探讨基于Macy模式的沟通培训方案对危重孕产妇进行医患沟通效果的影响。

采用前瞻性研究方法选取我院重症医学科自2023年1月至2024年6月收治的危重孕产妇198例及医护人员32名，按照不同的培训时间分组，分为对照组(医护人员16名，孕产妇102例，培训时间2023年1月至2023年9月)与观察组(医护人员16名，孕产妇96例，培训时间2023年10月至2024年6月)；对照组医护人员采取常规医患沟通培训，观察组医护人员实施医患Macy模式沟通培训，培训内容聚焦"启发患者观点、患者教育及治疗方案协商"等，对比两组医护人员培训前后的培训效果，同时对比两组培训后涉及到的198例危重孕产妇对医护人员沟通情况反馈的满意度。

观察组与对照组的"启发并理解患者的观点"评分分别为(3.50±0.42)分与(3.11±0.64)分(t＝2.038)、"协商并制定治疗方案"评分(3.49±0.42)分与(3.02±0.62)分(t＝2.094)、"患者教育"评分(3.30±0.56)分与(2.90±0.52)分(t＝2.511)，差异有统计学意义(P值均<0.05)；"准备与评估、信息收集、患者评估、查体过程中进行沟通及结束交流"两组评分比较，差异无统计学意义(P>0.05)。观察组危重症产妇的满意度为90例(93.80%)明显高于对照组77例(75.5%)( χ²＝11.245)，差异有统计学意义(P<0.05)。

基于Macy模式构建的沟通培训方案能够有效提升医护人员的沟通技能，危重孕产妇对此类沟通反馈出的满意度较高。

To investigate the effect of a Macy model-based communication training program on doctor-patient communication in critically ill pregnant women.

A prospective study was conducted, involving 198 critically ill pregnant women and 32 healthcare providers admitted to the Intensive Care Unit (ICU) of our hospital from January 2023 to June 2024. Participants were divided into two groups based on different training periods: a control group (16 healthcare providers and 102 pregnant women, trained from January 2023 to September 2023) and an observation group (16 healthcare providers and 96 pregnant women, trained from October 2023 to June 2024). Medical staff in the control group received conventional doctor-patient communication training, while those in the observation group underwent Macy model-based communication training, focusing on ″eliciting patient perspectives, patient education, and treatment plan negotiation.″ The training outcomes of medical staff in both groups were compared before and after training. Additionally, the satisfaction feedback from the 198 critically ill pregnant women regarding the communication with medical staff after training was compared between the two groups after training.

After the training, the scores of the observation group in ″eliciting and understanding the patient′s perspective, ″ ″shared decision-making, ″ and ″patient education″ were (3.50±0.42), (3.49±0.42), and (3.30±0.56) points, respectively. In comparison, the control group scored (3.11±0.64), (3.02±0.62), and (2.90±0.52) points in the corresponding domains. The post-training scores in these three aspects were significantly higher in the observation group than in the control group, with statistically significant differences (t=2.038, 2.094, 2.511; P<0.05). However, no statistically significant differences were found between the two groups after training in the domains of preparation and assessment, information gathering, patient evaluation, communication during physical examination, and closing the consultation (P>0.05). Moreover, the satisfaction rate of critically ill obstetric patients in the observation group was 93.80%, significantly higher than that in the control group (75.5%), with a statistically significant difference ( χ²=11.245, P<0.05).

The communication training program based on the Macy model effectively enhances the communication skills of healthcare providers, and critically ill pregnant women showed high satisfaction with this communication approach.