Objective To present literature on training patients in the use of effective communication skills. Methods Systematic searches were conducted in six databases. References were screened for inclusion through several phases. Extracted data included intervention study design, sample characteristics, content and structure of training programs, outcomes assessed, and findings reported. Results A total of 32 unique intervention studies were included. Most targeted primary care or cancer patients and used a randomized controlled study design. Interventions used a variety of training formats and modes of delivering educational material. Reported findings suggest that communication training is an effective approach to increase patients’ total level of active participation in healthcare interactions and that some communication behaviors may be more amenable to training (e.g., expressing concerns). Trained patients do not have longer visits and tend to receive more information from their providers. Most studies have found no relationship between communication training and improved health, psychosocial wellbeing, or treatment-related outcomes. Conclusions Findings reinforce the importance and potential benefits of patient communication training. Practice Implications Additional research is warranted to determine the most efficacious training programs with the strongest potential for dissemination.

Prolonged Grief Disorder (PGD) is a debilitating condition affecting between 7% and 10% of bereaved individuals. Past imaging and psychological studies have proposed links between PGD's characteristic symptoms -in particular, profound yearning -and the neural reward system. We conducted a systematic review to investigate this connection. On December 19, 2019, we searched six bibliographic databases for data on the neurobiology of grief and disordered grief. We excluded studies of the hypothalamic-pituitary-adrenal (HPA) axis, animal studies, and reviews. After abstract and full-text screening, twenty-four studies were included in the final review. We found diverse evidence for the activation of several reward-related regions of the brain in PGD. The data reviewed suggest that compared to normative grief, PGD involves a differential pattern of activity in the amygdala and orbitofrontal cortex (OFC); likely differential activity in the posterior cingulate cortex (PCC), rostral or subgenual anterior cingulate cortex (ACC), and basal ganglia overall, including the nucleus accumbens (NAc); and possible differential activity in the insula. It

Background: Survivors of cancer often describe a sense of abandonment post treatment, with heightened uncertainty, and limited knowledge of what lies ahead. This study examined the efficacy of a survivorship care planning intervention to help physicians address survivorship issues through communication skills training plus a new consultation focused on the use of a survivorship care plan for patients with Hodgkin’s lymphoma (HL) and diffuse large B-cell lymphoma (DLBCL). Methods: This cluster randomized, four-site trial examined the efficacy of a Survivorship Planning Consultation (SPC; physicians received communication skills training and applied these skills in a survivorship-focused office visit using a survivorship care plan) with patients who achieved complete remission after completion of first-line therapy versus a control arm in which physicians were trained to and subsequently provided a time-controlled, manualized Wellness Rehabilitation Consultation (WRC) focused only on discussion of healthy nutrition and exercise as rehabilitation post-chemotherapy. The primary outcomes for patients were changes in knowledge about lymphoma and adherence to physicians’ recommendations for vaccinations and cancer screenings. Results: Forty-two physicians and 198 patients participated across the four sites. Patients whose physicians were in the SPC arm had greater knowledge about their lymphoma (p = 0.01) and had greater adherence to physician recommendations for influenza vaccinations (p = 0.02) and colonoscopy (p = 0.02) than patients whose physicians were in the WRC arm. Conclusions: A dedicated consultation using a survivorship care plan and supported by communication skills training may enhance patient knowledge and adherence to some health promotion recommendations.

Background: Bereavement is associated with impaired mental health, increases in adverse health behaviors, and heightened risk of suicidal ideation, attempts, and death by suicide. The purpose of this literature review was to explore associations between cause of death and suicidal thoughts among bereaved individuals. Our aim was to compare incidence of suicidal ideation by cause of death and identify gaps in this literature to guide future research and clinical intervention. Methods: PRISMA-P guidelines were used to structure an electronic literature search in the PsycINFO, MEDLINE, and Web of Science databases. The search focused on English language studies that were published before February 2019 and sought to compare rates of suicidal ideation among bereaved people who lost a loved one to suicide, accidental overdose, cancer, dementia, cardiovascular disease, and HIV/AIDs. Results: Nine articles were identified with suicide as cause of death, zero articles for accidental overdose, zero articles for cardiovascular disease, seven articles for cancer, one article for dementia, and one article for HIV/AIDs. Given the limited number of articles generated by our search, a formal meta-analysis was not appropriate. However, a comparison of results did suggest that suicide bereavement was associated with the highest rates of suicide ideation (14.1% to 49%). Stigma, isolation, avoidance behaviors, and psychological distress were associated with suicidal thoughts among bereaved individuals, regardless of the deceased’s cause of death. Conclusions: Findings of this literature search revealed significant gaps in the literature, especially regarding thoughts of suicide in bereaved survivors of accidental overdose and cardiovascular disease. Results suggest that multiple causes of death are associated with suicidal ideation in bereavement, but that suicide bereavement may be the cause of death associated with the highest risk of suicidal ideation. More research is needed to understand the ways in which cause of death influences prevalence, risk, and protective factors associated with suicidal thoughts among bereaved individuals.

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