Addressing the Transition from Curative to Palliative Care: Concept and Acceptance of a Specific Communication Skills Training for Physicians in Oncology – COM-ON-p

Abstract

Background: There are several reasons why consultations addressing the transition to palliative care are especially challenging, and physicians are generally not very well prepared to meet these challenges. We therefore conceptualized and evaluated a concise, individualized communication skills training (CST) addressing i) communication concerning the transition to palliative care, and ii) involvement of significant others in the conversation. Core aspects of the CST and data of acceptance will be presented. Methods: The core elements of the CST are a 1.5-day workshop held in small groups and a subsequent individual coaching session during everyday routine. The workshop is practice-oriented and highly individualized. Acceptance was assessed by using a self-developed 13-item questionnaire. Results: All 41 participating physicians completed the evaluation questionnaire. The participants’ overall evaluation of the workshop was very positive and indicated a high personal benefit. Individualized learning tools like ‘assessment of individual learning goals’ and ‘closing with individual take-home messages’ were also seen as positive, but not as positive as other elements like practicing with actor patients and feedback from actors and facilitators. Conclusions: The presented specific, individualized, and concise CST is well accepted, and physicians see a high practical relevance and strong personal benefits.

Working Through Grief and Loss: Oncology Nurses' Perspectives on Professional Bereavement

“…Oncology care focuses on providing cure whenever possible, as well as comfort and palliative care in cases in which cure is not achievable (Bakitas et al, 2009; Goelz et al, 2010). In particular, the dilemma of cure and end-of-life care has been found to influence oncology nurses and contribute to high burden and stress (Rohan & Bausch, 2009; Sehlen et al, 2009).…”

Core components of Communication Skills Training in oncology: A synthesis of the literature contrasted with consensual recommendations

“…The first authors of the included articles were affiliated with institutes from the following countries: the USA n = 14 [1, 2, 6, 9, 10, 12, 13, 16-18, 20, 32, 34, 42] , Switzerland n = 7 [3-5, 8, 31, 37, 44] , the UK n = 5 [7,21,30,39,46] , Germany n = 5 [27,28,40,48,49] , Australia n = 5 [11,14,15,19,29] , Japan n = 4 [22][23][24][25] , Belgium n = 4 [26,33,35,36] , the Netherlands n = 1 [47] , China n = 1 [41] , Taiwan n = 1 [45] , Italy n = 1 [38] and Canada n = 1 [43] . Most authors worked together in eight research groups, and three articles were co-authored by members of separate research groups.…”

Transition from curative to palliative care in cancer

“…[122] The transition to palliative care becomes smooth when the doctors communicate the disease status and prognosis, the questions and emotions of patients and families are adequately answered, and a discussion about palliative care is done. [23] For an improved patient-physician relationship, the values and wishes of a terminal-stage patient (and relatives) should be adequately evaluated by the medical team. [22]…”

“…[32325] Important issues in the transition from curative treatment to palliative care are agreement, timing, and decision-making. [3] The availability of health professionals trained in the delivery of palliative care is a major limitation in many countries.…”