[討論] 20190924 議題

討論議題

Q1.    SMI及MMQ寫作討論 [SMI檔案已於昨天傳至Skype]

Q2.    SMI表三中缺乏數據資料，是否需要寄信給原作者?

Q3.  溝通技巧訓練之要素表格重整如下：
        先前用Elements來表示，語意上不合適，若改成training theme不知是否較能呼應其內涵?

Training themes/ elements of the CST [1]	Key points
1.    Eliciting the patient’s agenda	Ÿ  Building relationships Ÿ  Allow patients to speak Ÿ  Arrange the interview sequence Ÿ  Active listening Ÿ  Symptom assessment
2.    Understand the patient's perspective	Ÿ  Asking the patient about his or her understanding of the cause of the illness Ÿ  Understanding the patient’s beliefs Ÿ  Exploring the patient’s feelings Ÿ  Understanding of the patient’s values and resources. Ÿ  Explore the effects of the illness on personal activities and social responsibilities Ÿ  Perceive patients’ expectations Ÿ  Explored the patient’s underlying concerns
3.    Expression empathy	Ÿ  Understand the patient’s illness experience and emotions. Ÿ  Show concern and interest verbally and through facial expressions.
4.    Breaking bad news	Ÿ  Assessing the patient’s prior knowledge and understanding of the illness, and the patient’s preference for an overview vs. detailed information Ÿ  Techniques: Setting, Perception, Invitation, Knowledge, Emotions, and Strategy Ÿ  Ensure privacy Ÿ  Avoid distractions and interruptions Ÿ  Involve significant others Ÿ  Sit down, and connect with the patient. Ÿ  Use words that are familiar to patients. Ÿ  Avoid medical jargon. Ÿ  Do not be excessively blunt or insensitive. Ÿ  Provide information in small chunks and allow time for comprehension. Ÿ  Do not take away hope because patients may have other, nonmedical goals.
5.    Shared decision making (SDM)	Ÿ  The pros and cons of each option should be outlined, including benefits, risks (potential immediate and long-term adverse effects or complications), and costs (direct and indirect) Ÿ  Asking about the patient’s previous knowledge of the illness Ÿ  Providing small chunks of information and checking for understanding after each chunk (ask-tell-ask technique).

Q4.    週五寫作課可否用MMQ去報告?