Practical exploration of Balint groups in improving emotion management and doctor-patient communication skills of residents

Wang Xuemei; Zhou Jinyi; Yang Yuyin; Qi Jiajun

doi:10.3760/cma.j.cn116021-20230712-01611

您当前的位置：

首页 >

文章列表页 >

Practical exploration of Balint groups in improving emotion management and doctor-patient communication skills of residents

Standardized Residency Training | 更新时间：2024-12-26

- Practical exploration of Balint groups in improving emotion management and doctor-patient communication skills of residents
- Chinese Journal of Medical Education Research Vol. 23, Issue 12, Pages: 1713-1718(2024)
- 作者机构：
  
  1.苏州大学附属第一医院精神医学科，苏州　215006
  2.苏州大学附属第一医院临床技能中心，苏州　215006
- 作者简介：
  
  Qi Jiajun, Email: qjjss2000@163.com
- 基金信息：
  
  General Program of Research on Hospital Management Innovation of Jiangsu Hospital Association(JSYGY-3-2021-171);Higher Education Reform Project of Soochow University(苏大教〔2021〕108号);Standardized Training Research Project for Residents of the First Affiliated Hospital of Soochow University(ZPKJ20210207)
- DOI：10.3760/cma.j.cn116021-20230712-01611
  CLC： R197.3
- Published：20 December 2024，
  
  Received：12 July 2023，
- 稿件说明：
移动端阅览
王雪梅, 周金懿, 杨昱音, 等. 巴林特小组对提升住院医师情绪管理和医患沟通能力的实践探索[J]. 中华医学教育探索杂志, 2024, 23(12): 1713-1718.

WANG XUEMEI, ZHOU JINYI, YANG YUYIN, et al. Practical exploration of Balint groups in improving emotion management and doctor-patient communication skills of residents. [J]. Chinese journal of medical education research, 2024, 23(12): 1713-1718.
王雪梅, 周金懿, 杨昱音, 等. 巴林特小组对提升住院医师情绪管理和医患沟通能力的实践探索[J]. 中华医学教育探索杂志, 2024, 23(12): 1713-1718. DOI： 10.3760/cma.j.cn116021-20230712-01611.

WANG XUEMEI, ZHOU JINYI, YANG YUYIN, et al. Practical exploration of Balint groups in improving emotion management and doctor-patient communication skills of residents. [J]. Chinese journal of medical education research, 2024, 23(12): 1713-1718. DOI： 10.3760/cma.j.cn116021-20230712-01611.

摘要

目的

探索巴林特小组对住院医师在规范化培训期间的情绪稳定及提升处理医患关系和沟通能力的作用，为将巴林特小组活动纳入住院医师规范化培训的日常管理，作为岗位胜任力中的重要课程提供依据。

方法

2021年2月至12月，采用简单随机对照研究法，将苏州大学附属第一医院40名住培医师分为2组。其中20名进入“试验组”，参与封闭性巴林特小组活动；另外20名不参与巴林特小组活动，作为“对照组”。使用焦虑自评量表（generalized anxiety disorder-7，GAD-7）、抑郁自评量表（patient health questionnaire-9，PHQ-9）和医患沟通技能评价量表（set the stage，elicit information，give information，understand the patient’ s perspective，and end the encounter，SEGUE），评估两组住培医师在参加巴林特小组第3个月、第6个月及第9个月时的情绪状态、医患关系处理及医患沟通能力。采用SPSS 22.0软件进行

检验，对3组及以上的组间比较采用方差分析；对于涉及2个因素的重复测量数据，采用重复测量方差分析。

结果

在焦虑状态评估中，试验组住院医师在第6个月至第9个月评分逐渐下降，时间和组别的交互效应（

=14.57，

0.001）差异均具有统计学意义。在抑郁状态评估中，时间和组别交互效应（

=33.25，

0.001）差异有统计学意义，试验组住院医师的抑郁自评分逐渐下降，且两组差异逐渐增加。相较于对照组，试验组在信息收集、信息给予、理解患者3个维度有更加明显的提升，差异均具有统计学意义；且与自身基线比较，随访9个月后，试验组SEGUE量表总分有明显提升[（107.20±2.16） vs. （92.55±4.37），

=7.26，

0.001

]

。重复测量方差分析显示，评估时间和组别的交互作用下，两组住院医师在信息给予（

=3.01，

=0.045）和SEGUE量表总分（

=6.29，

=0.002）上差异均具有统计学意义。

结论

参与巴林特小组有助于改善住培医师焦虑、抑郁情绪，在维持稳定情绪方面有重要作用。巴林特小组对住院医师提高医患沟通能力有重要帮助，尤其是在信息收集、信息反馈给予、理解病人等方面。

Abstract

Objective

To explore the effects of Balint Group on the emotional stability of residents during the standardized training and the improvement of doctor-patient relationship and communication ability

so as to provide a basis for incorporating the activities of Balint Group into the daily management of the standardized training of residents and as an important course in post competency.

Methods

From February to December 2021

a simple randomized controlled study was conducted at the First Affiliated Hospital of Suzhou University

40 residents were selected and assigned to two groups. Twenty residents were enrolled in the "experimental group" to participate in the closed Balint group activities; another 20 residents did not participate in the Balint group activities and were treated as the "control group". Tools of Generalized Anxiety Disorder-7

Patient Health Questionnaire-9

and Set the stage

Elicit information

Give information

Understand the patient's perspective

and End the encounter (SEGUE) were applied to evaluate the emotional state

doctor-patient relationship management

and doctor-patient communication skills of residents in the two groups in the third month

sixth month and ninth month of participating in the Balint group. SPSS 22.0 software was used for

test

and comparison among three or more groups was conducted by analysis of variance. Repeated measures data involving two factors were analyzed by repeated measures analysis of variance.

Results

In the assessment of anxiety state

the scores in the experimental group decreased gradually from the sixth month to the ninth month

and there was a significant difference in the interaction effect between time and group (

=14.57

0.001). In the assessment of depressive state

there was a significant difference in the interaction effect between time and group (

=33.25

0.001)

and the depression self-score in the experimental group decreased gradually

with an gradually increased difference between the two groups. Compared with the control group

the experimental group had significantly improvements in three dimensions of information collection

information giving

and understanding of patients. The total SEGUE score in the experimental group was improved significantly after nine months of training compared wi

th the baseline value [(107.20±2.16) vs. (92.55±4.37)

=7.26

0.001

]

. The repeated measures analysis of variance showed that there were significant differences between the two groups in terms of information giving (

=3.01

=0.045) and total SEGUE score (

=6.29

=0.002) under the assessment of interaction between time and group.

Conclusions

Balint groups can alleviate residents' anxiety and depression and play an important role in maintaining stable mood. Balint groups have an advance effect on improving residents' doctor-patient communication skills

especially in information collection

information feedback and giving

and understanding of patients.

关键词

巴林特小组情绪管理医患沟通医患沟通技能评价量表

Keywords

Balint groupEmotion managementDoctor-patient communicationSet the stage Elicit information Give information Understand the patient's perspective and End the encounter

references

Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world [J]. Rev Peru Med Exp Salud Publica, 2011, 28(2): 337-341. DOI: 10.1590/s1726-46342011000200023http://dx.doi.org/10.1590/s1726-46342011000200023.

Sklar J. Regression and new beginnings: Michael, Alice and Enid Balint and the circulation of ideas [J]. Int J Psychoanal, 2012, 93(4): 1017-1034. DOI: 10.1111/j.1745-8315.2012.00559.xhttp://dx.doi.org/10.1111/j.1745-8315.2012.00559.x.

Makoul G. The SEGUE Framework for teaching and assessing communication skills [J]. Patient Educ Couns, 2001, 45(1): 23-34. DOI: 10.1016/s0738-3991(01)00136-7http://dx.doi.org/10.1016/s0738-3991(01)00136-7.

李娟. 用SEGUE量表对医学生医患沟通技能评价的研究[D]. 沈阳：中国医科大学， 2008.

Centeno-Gándara LA. Improving the physician-patient relationship utilizing psychodynamic psychology: a primer for health professionals [J]. Health Psychol Behav Med, 2021, 9(1): 338-349. DOI: 10.1080/21642850.2021.1914052http://dx.doi.org/10.1080/21642850.2021.1914052.

Zhang XJ, Song Y, Jiang T, et al. Interventions to reduce burnout of physicians and nurses: an overview of systematic reviews and meta-analyses [J]. Medicine, 2020, 99(26): e20992. DOI: 10.1097/MD.0000000000020992http://dx.doi.org/10.1097/MD.0000000000020992.

郑丽华，魏江辉，苏海桓. 巴林特小组改善医护人员职业压力与职业倦怠的效果 [J]. 中国当代医药， 2019， 26（29）： 175-178. DOI: 10.3969/j.issn.1674-4721.2019.29.051http://dx.doi.org/10.3969/j.issn.1674-4721.2019.29.051.

张辉，王苗苗，张岩. 聚焦于改善医患关系的继续医学教育探讨：巴林特小组介绍及启示 [J]. 中国社会医学杂志， 2015， 32（1）： 26-28 . DOI: 10.3969/j.issn.1673-5625.2015.01.010http://dx.doi.org/10.3969/j.issn.1673-5625.2015.01.010.

van Roy K, Vanheule S, Inslegers R. Research on Balint groups: a literature review [J]. Patient Educ Couns, 2015, 98(6): 685-694. DOI: 10.1016/j.pec.2015.01.014http://dx.doi.org/10.1016/j.pec.2015.01.014.

Jing W, Otten H, Sullivan L, et al. Improving the doctor-patient relationship in China: the role of balint groups [J]. Int J Psychiatry Med, 2013, 46(4): 417-427. DOI: 10.2190/PM.46.4.ghttp://dx.doi.org/10.2190/PM.46.4.g.

Yazdankhahfard M, Haghani F, Omid A. The Balint Group and its application in medical education: a systematic review [J]. J Educ Health Promot, 2019, 8: 124. DOI: 10.4103/jehp.jehp_423_18http://dx.doi.org/10.4103/jehp.jehp_423_18.

McCarron R, FitzGerald JM, Swann P, et al. A mixed-methods SWOT analysis of a medical student Balint Group programme [J]. Med Teach, 2024，46（1）: 132-139. DOI: 10.1080/0142159x.2023.2239999http://dx.doi.org/10.1080/0142159x.2023.2239999.

Elzain M, Murthy S, Omer S, et al. Reflective practice in psychiatric training: Balint groups during COVID-19 [J]. Ir J Psychol Med, 2023, 40(3): 326-329. DOI: 10.1017/ipm.2022.51http://dx.doi.org/10.1017/ipm.2022.51.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Application of the "Balint group" in the doctor-patient communication skills training for standardized residency training of internal medicine

Study on the effect of Peer Balint-style group on empathy ability of third-year long-term medical students

Effectiveness of regular two-way quality feedback combined with Balint group technique for enhancing the core competencies of nurses in department of cardiology

A study on using comprehensive geriatric assessment to improve the teaching level of doctor-patient communication from the perspective of Johari Window

Related Author

周巍

谭韡

肖文静

吕小斌

Liu Haohui

Lin Zhichao

Chen Tianzhu

Liang Huaifeng

Related Institution

武汉大学人民医院消化内科

First College of Clinical Medicine, Guangzhou University of Chinese Medicine

Section of Youth League Committee, The First Affiliated Hospital of Guangzhou University of Chinese Medicine

Department of Scientific Research, The First Affiliated Hospital of Guangzhou University of Chinese Medicine

Department of Cardiovascular Medicine, The First Affiliated Hospital of Air Force Medical University

⁰