Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial (original) (raw)
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Tumori Journal, 2015
Aims and Background This study is aimed at evaluating the effectiveness of a physician-centered communication skills training program on cancer patient anxiety levels. Methods and Study design In this quasi-experimental study, physicians from 9 units of 5 general hospitals and 1 cancer research institute were recruited. The unit heads chose which physicians would attend the training program (treatment group) and which would not (control group). The effectiveness of the course was evaluated by assessing the evolution of state anxiety in a sample of cancer patients before and after clinical consultations. Results Thirty-eight physicians and 339 outpatients were assessed. Patients from the treatment and control groups did not differ in pre-examination anxiety or psychological distress levels. Patients examined by physicians from the treatment group displayed a higher decrease in state-anxiety levels compared with those examined by physicians from the control group. A higher proportion ...
BMC cancer, 2017
Although previous studies have reported the efficacy of communication skills training (CST) programs, specific training addressing communication about uncertainty and hope in oncology has not yet been studied. This paper describes the study protocol of a randomized controlled trial assessing the efficacy of a CST program aimed at improving physician ability to communicate about uncertainty and hope in encounters with cancer patients. Physician participants will be randomly assigned in groups (n = 3/group) to a 30-h CST program (experimental group) or to a waiting list (control group). The training program will include learner-centered, skills-focused, practice-oriented techniques. Training efficacy is assessed in the context of an encounter with a simulated advanced stage cancer patient at baseline and after the CST for the experimental group, and after four months for the waiting-list group. Efficacy assessments will include communicational, psychological and physiological measures...
Patient education and counseling, 2016
This study tested the effectiveness of a brief, learner-centered, breaking bad news (BBN) communication skills training module using objective evaluation measures. This randomized control study (N=66) compared intervention and control groups of students (n=28) and residents' (n=38) objective structured clinical examination (OSCE) performance of communication skills using Common Ground Assessment and Breaking Bad News measures. Follow-up performance scores of intervention group students improved significantly regarding BBN (colon cancer (CC), p=0.007, r=-0.47; breast cancer (BC), p=0.003, r=-0.53), attention to patient responses after BBN (CC, p<0.001, r=-0.74; BC, p=0.001, r=-0.65), and addressing feelings (BC, p=0.006, r=-0.48). At CC follow-up assessment, performance scores of intervention group residents improved significantly regarding BBN (p=0.004, r=-0.43), communication related to emotions (p=0.034, r=-0.30), determining patient's readiness to proceed after BBN and...
Observed communication between oncologists and patients: A causal model of communication competence
World Journal of Meta-Analysis, 2014
Articles published by this Open-Access journal are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. CORE TIP The meta-analysis provides advice about how to deliver the diagnosis of cancer to a patient that promotes more acceptance. The more constructive reaction a patient has to negative news increases adherence and speed of treatment. The focus on communication that is patient-centered creates the basis for improved clinical practice.
JAMA Oncology, 2016
IMPORTANCE Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. OBJECTIVE To determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote patient-centered communication, and to estimate intervention effects on shared understanding, patient-physician relationships, QOL, and aggressive treatments in the last 30 days of life. DESIGN, SETTING, AND PARTICIPANTS Cluster RCT at community-and hospital-based cancer clinics in Western New York and Northern California; 38 medical oncologists (mean age 44.6 years; 11 (29%) female) and 265 community-dwelling adult patients with advanced nonhematologic cancer participated (mean age, 64.4 years, 146 [55.0%] female, 235 [89%] white; enrolled August 2012 to June 2014; followed for 3 years); 194 patients had participating caregivers. INTERVENTIONS Oncologists received individualized communication training using standardized patient instructors while patients received question prompt lists and individualized communication coaching to identify issues to address during an upcoming oncologist visit. Both interventions focused on engaging patients in consultations, responding to emotions, informing patients about prognosis and treatment choices, and balanced framing of information. Control participants received no training. MAIN OUTCOMES AND MEASURES The prespecified primary outcome was a composite measure of patient-centered communication coded from audio recordings of the first oncologist visit following patient coaching (intervention group) or enrollment (control). Secondary outcomes included the patient-physician relationship, shared understanding of prognosis, QOL, and aggressive treatments and hospice use in the last 30 days of life. RESULTS Data from 38 oncologists (19 randomized to intervention) and 265 patients (130 intervention) were analyzed. In fully adjusted models, the intervention resulted in clinically and statistically significant improvements in the primary physician-patient communication end point (adjusted intervention effect, 0.34; 95% CI, 0.06-0.62; P = .02). Differences in secondary outcomes were not statistically significant. CONCLUSIONS AND RELEVANCE A combined intervention that included oncologist communication training and coaching for patients with advanced cancer was effective in improving patient-centered communication but did not affect secondary outcomes. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01485627
Assessment of the efficacy of communication skills training program for oncologists
Acta medica Lituanica, 2016
Background. Effective communication is essential for cancer care therefore a communication skills training program was developed by the Lithuanian Association of Psychosocial Oncology. This study aims to identify the efficacy of the new program designed for Lithuanian specialists. Materials and methods. Self-report questionnaires for health care professionals were designed. Surveys were based on three topics – stress, confidence level, and personal opinion about the training and ability to apply learned communication skills. 88(67.2%) respondents completed the questionnaire. Results.…
Objective: To evaluate whether a consultation skills training (CST) program with oncologists and trainees would improve skills in detecting and responding to patient distress, thereby improving their patients’ emotional functioning and reducing psychological distress. Methods: Randomized-controlled trial with 29 medical and radiation oncologists from Australia randomized to CST group (n = 15) or usual-care group (n = 14). The CST consisted of a 1.5-day face-toface workshop incorporating presentation of principles, a DVD modelling ideal behaviour and role-play practice, and four 1.5 h monthly video-conferences. At the CST conclusion, patients of participating doctors were recruited (n = 192 in CST group, n = 183 in usual-care group), completing telephone surveys at baseline, 1 week and 3 months to assess quality of life, anxiety, depression and unmet psychosocial needs. Results: Despite high patient functioning at baseline, anxiety significantly improved at 1-week followup in the CST group, compared to the control group. There were no statistically significant differences in emotional functioning, depression or unmet supportive care need between the groups. Conclusion: Consistent trends for greater improvements were observed in intervention compared to control group patients, suggesting the CST program deserves wider evaluation. Practice implications: Video-conferencing after a short training course may be an effective strategy for delivering CST.