Formación en comunicación para profesionales sanitarios / Communication training for health professionals

La profunda transformación vivida en el ámbito sanitario en general, y en concreto en el cambio de modelo relacional con el desarrollo del modelo centrado en la persona, requiere de nuevas maneras de enfocar la formación de los profesionales sanitarios, no tan solo con la incorporación de nuevos conocimientos sino también en el desarrollo de las competencias en habilidades comunicativas y relacionales. Este artículo presenta una propuesta de formación en comunicación de malas noticias para los profesionales sanitarios, atendiendo a las actitudes, habilidades y a los conocimientos necesarios para hacerlo. Se presenta un modelo de docencia escalar y adaptable a diferentes contextos y especialidades sanitarias (AU)

Healthcare has undergone profound changes in recent decades. These changes impact, among others, the relational model, making it necessary to develop a person-centered model. To accomplish this, an update in the training of health professionals, incorporating new knowledge associated with communication and relational skills is necessary. This article presents a proposal for training in bad news communication for healthcare professionals, considering the attitudes, skills and knowledge necessary to do so. A scalar training model, adaptable to different contexts and health specialties, is presented (AU)

La profunda transformació viscuda en l'àmbit sanitari en general, i en concret en el canvi de model relacional amb el desenvolupament del model centrat en la persona, requereix de noves maneres d'enfocar la formació dels professionals sanitaris, no tan sols amb la incorporació de nous coneixements sinó també en el desenvolupament de les competències en habilitats comunicatives i relacionals. Aquest article presenta una proposta de formació en comunicació de males notícies per als professionals sanitaris, ateses les actituds, habilitats i als coneixements necessaris per a fer-ho. Es presenta un model de docència escalar i adaptable a diferents contextos i especialitats sanitàries (AU)

Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study).

INTRODUCTION: The IMPACT study focuses on chronic low back pain (CLBP) and depression symptoms, a prevalent and complex problem that represents a challenge for health professionals. Acceptance and Commitment Therapy (ACT) and Brief Behavioural Activation Treatment for Depression (BATD) are effective treatments for patients with persistent pain and depression, respectively. The objectives of this 12 month, multicentre, randomised, controlled trial (RCT) are (i) to examine the efficacy and cost-utility of adding a group-based form of ACT or BATD to treatment-as-usual (TAU) for patients with CLBP and moderate to severe levels of depressive symptoms; (ii) identify pre-post differences in levels of some physiological variables and (iii) analyse the role of polymorphisms in the FKBP5 gene, psychological process measures and physiological variables as mediators or moderators of long-term clinical changes. METHODS AND ANALYSIS: Participants will be 225 patients with CLBP and moderate to severe depression symptoms recruited at Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat, Spain) and Hospital del Mar (Barcelona, Spain), randomly allocated to one of the three study arms: TAU vs TAU+ACT versus TAU+BATD. A comprehensive assessment to collect clinical variables and costs will be conducted pretreatment, post-treatment and at 12 months follow-up, being pain interference the primary outcome measure. The following physiological variables will be considered at pretreatment and post-treatment assessments in 50% of the sample: immune-inflammatory markers, hair cortisol and cortisone, serum cortisol, corticosteroid-binding globulin and vitamin D. Polymorphisms in the FKBP5 gene (rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916) will be analysed at baseline assessment. Moreover, we will include mobile-technology-based ecological momentary assessment, through the Pain Monitor app, to track ongoing clinical status during ACT and BATD treatments. Linear mixed-effects models using restricted maximum likelihood, and a full economic evaluation applying bootstrapping techniques, acceptability curves and sensitivity analyses will be computed. ETHICS AND DISSEMINATION: This study has been approved by the Ethics Committee of the Fundació Sant Joan de Déu and Hospital del Mar. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media and various community engagement activities. TRIAL REGISTRATION NUMBER: NCT04140838.