目的：
本研究旨在探討護理人員在接受2天癌症溝通訓練方案後其溝通能力、技巧與自信的成效分析。
方法：
採單組、前後測類實驗研究設計，立意取樣，研究對象為台灣南部醫學中心及區域醫院之護理人員，共收集71位曾經照顧過癌症病患的臨床護理人員。
研究工具：
溝通技巧（Medical Interview Aural Rating Scale, MIARS）、(2) 研究者評量的基本溝通能力（Kalamazoo Essential Element Communication Checklist, KEECC-R）、(3) 護理人員自評的基本溝通能力（Kalamazoo Essential Element Communication Checklist, KEECC-N）、(4) 溝通自信（Nurses’ Self-Efficacy Ratings in Oncology Specified Communication Tasks Scale, NSORSCT）、(5)病患滿意度（Rochester Communication Rating Scale, RCRS）。在癌症教育訓練前一週、後一週進行前測、後測，收集多元的結果指標包括護士、模擬癌症病人自填量表與研究者評量15分鐘護士病人會談分數。
介入方案：
二天癌症溝通訓練方案包括課程及小組演練，癌症溝通課程講授（6小時），以授課、影片教學、影片回顧及提問和討論進行；小組模擬癌症溝通演練（6小時），以角色扮演、現場示範及立即回饋的方式進行。
結果：
2位經訓練之研究員藉觀察分析軟體、量表以評量護理人員的溝通技巧和溝通能力，資料以描述性和推論性統計分析。研究發現2天癌症溝通訓練方案對護理人員在溝通能力有顯著改善，能夠提升其溝通技巧、基本溝通能力、溝通自信及病患滿意度。
結論：
2天癌症溝通訓練方案可以增加護理人員在情緒線索的探索與確認、正向回應的行為；減少跳脫策略、負向回應的行為等。並提升其再面對病人的溝通自信。
未來應用：
期待本研究結果可作為未來癌症溝通教育介入方案之參照架構與應用教材。

Objectives: To validate the effectiveness of a two-day cancer communication skill training program on nurse staffs in their communication competence, skills and confidence.
Methods: A single group with quasi-experimental pre- and post-test research design was used. 71 nurses having cancer care experience were recruited from medical centers and regional hospital in Southern Taiwan.
Instruments: Five instruments were used to assess the outcomes at 1 week before and 1 week after communication training program. There were including: Medical Interview Aural Rating Scale (MIARS), Kalamazoo Essential Element Communication Checklist-researcher rated (KEECC-R), Kalamazoo Essential Element Communication Checklist-nurse rated (KEECC-N), Nurses' Self-Efficacy Ratings in Oncology Specified Communication Tasks Scale (NSORSCT), and Rochester Communication Rating Scale (RCRS). The multiple outcome indexes were collected through nurse’s and simulated patient’s self-rating scores (KEECC-N, NSORSCT, RCRS), and researcher coding and rating scores from a15-min nurse-patient interview (MIARS, KEECC-R).
Intervention：Participants attended a two-day communication skills training programme. The program began with a large group meeting for 6 hours, focusing on theoretic information, open discussions. Nurses were then divided into small groups of 3 or 4, in which one facilitators were assigned for 6 hours. One participant volunteered to play a nurse and another to play a patient in various scenarios involving a nurse’s follow-up situation. We prepared the following 4 scenarios, which took into account a suitable Taiwan medical system and culture.
Results:
Nurses’ communication competence and skills were coded and rated by two trained researchers independently based on The Observer XT coding software and MIARS. The descriptive and inferential statistics were used to analyze the data. The significant changes were found in MIARS, KEECC-R, NSROSCT and RCRS after a two-day cancer communication training program.
Conclusions: Nurses’ confidence, emotional responding behaviors and facilitating behaviors increased including cue exploration and acknowledge; the distancing strategy and blocking behavior decreased after intervention.
Implication: The intervention protocol and teaching materials would apply for the periodical training frame in promoting oncology nurses’ communication competence and confidence.

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