Discussion of emotional and social impact of cancer during outpatient oncology consultations

Taylor, Sally; Harley, Clare; Campbell, Lyndsay J.; Bingham, Laura; Podmore, Emma; Newsham, Alex; Selby, Peter J.; Brown, Julia; Velikova, Galina

doi:10.1002/pon.1730

Cited by 56 publications

(49 citation statements)

References 24 publications

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“…Prior studies also suggest there are particular challenges to increasing trainees' skill in responding to affective aspects of communicating bad news. 26 Two other recent studies have reported similar difficulties with improving trainees' ability to explore patient emotions in response to bad news. 15,16 One of these was a randomized trial 15 and the other was a training program for end-of-life communication with physician trainees in Australia.…”

Section: Discussionmentioning

confidence: 95%

Interprofessional Communication Skills Training for Serious Illness: Evaluation of a Small-Group, Simulated Patient Intervention

Bays

Engelberg

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et al. 2014

Journal of Palliative Medicine

122

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Background: Communication with patients and families is an essential component of high-quality care in serious illness. Small-group skills training can result in new communication behaviors, but past studies have used facilitators with extensive experience, raising concerns this is not scalable. Objective: The objective was to investigate the effect of an experiential communication skills building workshop (Codetalk), led by newly trained facilitators, on internal medicine trainees' and nurse practitioner students' ability to communicate bad news and express empathy. Design: Trainees participated in Codetalk; skill improvement was evaluated through pre-and post-standardized patient (SP) encounters. Setting and subjects: The subjects were internal medicine residents and nurse practitioner students at two universities. Intervention and measurements: The study was carried out in anywhere from five to eight half-day sessions over a month. The first and last sessions included audiotaped trainee SP encounters coded for effective communication behaviors. The primary outcome was change in communication scores from pre-intervention to postintervention. We also measured trainee characteristics to identify predictors of performance and change in performance over time. Results: We enrolled 145 trainees who completed pre-and post-intervention SP interviews-with participation rates of 52% for physicians and 14% for nurse practitioners. Trainees' scores improved in 8 of 11 coded behaviors ( p < 0.05). The only significant predictors of performance were having participated in the intervention ( p < 0.001) and study site ( p < 0.003). The only predictor of improvement in performance over time was participating in the intervention ( p < 0.001). Conclusions: A communication skills intervention using newly trained facilitators was associated with improvement in trainees' skills in giving bad news and expressing empathy. Improvement in communication skills did not vary by trainee characteristics.

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Section: Discussionmentioning

confidence: 95%

Interprofessional Communication Skills Training for Serious Illness: Evaluation of a Small-Group, Simulated Patient Intervention

Bays

Engelberg

Back

et al. 2014

Journal of Palliative Medicine

122

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“…Tedaviyle ilişkili fiziksel ve sosyal sorunları, tekrarlama riskinden dolayı korku, anksiyete ve depresyon gibi duygusal sıkıntıları bilmek istemektedirler. [18,19] Bu aşamada hastaların baş etme stratejilerini öğrenmeleri önemlidir. [13,16] Birey olarak sağlık profesyonelleri tarafından hatırlanmak anksiyetelerinin azalmasına yardımcı olabilir.…”

Section: Introductionunclassified

“…[12] Ayrıca hastaların eğlence aktiviteleri, aile konuları ve tatiller gibi sosyal konular hakkında bilgi ve desteğe gereksinimleri vardır. [19] Hastalar hemşireden hakkını savunmasını [15] ve duygularını paylaşmasını istemektedir. [16] Hastaların yeni durumu anlamak ve özümsemek için desteğe gereksinimleri vardır.…”

Section: Introductionunclassified

Investigation of Cancer Patients’ Information Sources, Information Needs and Expectations of Health Professionals

BASKALE¹

2015

Psi Hem Derg

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ÖZETAmaç: Bu çalışmanın amacı kanser hastalarının bilgi kaynaklarını, bilgi gereksinimlerini ve sağlık personelinden beklentilerini incelemektir. Gereç ve Yöntem:Araştırma tanımlayıcı olarak yapılmıştır. Araştır-manın örneklemini Türkiye'de en sık kullanılan kanserle ilgili bir bloğun kullanıcıları olan, araştırmaya katılmayı kabul eden 120 kanser hastası oluşturmuştur. Veri toplama aracı olarak araştırmacılar tarafından literatüre dayalı olarak hazırlanan Hastaların Sağlık Personelinden Beklentileri isimli anket formu kullanılmıştır.Bulgular: Çalışmaya katılan kanser hastalarının %82.5'i hastalıkla ilgili bilgiyi doktordan, %70.8'i internetten almaktadır. Buna karşılık hastaların %97.5'i doktordan, %39.2'si hemşireden bilgi almak istemektedirler. Hastaların %45.8'i sağlık personelinin iletişimini kısmen yeterli, %35.0'i yetersiz, %19.2'si yeterli olarak belirtmiştir. Hastaların doktorlardan beklentileri; tedavi ve hastalık hakkında bilgi alma, anlayış, daha iyi bir iletişim kurması, duygusal destek alma, hastalık ve tedavi hakkında karar vermede destek olması, saygı göstermesi ve daha fazla zaman ayırması/dinlemesidir. Hastaların hemşirelerden beklentileri; anlayış, saygı, daha iyi bir iletişim kurması, bakımın daha iyi olması ve duygusal destek almadır. Hastalar sağlık personelinden tedavi ve yan etkileri, hastalığın tekrarlama ihtimali, hastalığın psikolojik durum üzerine etkileri, prognoz, tedavinin ne kadar süreceği ve hastalık (ne olduğu ve nedenleri) gibi konularda bilgi almak istemektedir.Sonuç: Sağlık personelinin hastalığın ve tedavinin her aşamasında hastayı bilgilendirmesi, dinlemesi, anlayışlı olması ve desteklemesi önemlidir. Ayrıca sağlık personeli hastalar tarafından kullanılan bilgi kaynaklarının farkında olmalıdır. Karmaşık tıbbi bilgiler, zor tedavi kararları almak, tedavinin yan etkileriyle mücadele etmek, hastalığın tekrarlama ve yaklaşan ölüm riski nedeniyle hastaların yaşam kaliteleri zamanla düşmektedir. [1] Bu zor süreçte hastaların sağlık profesyonellerinden beklentileri artmaktadır. Hastaların beklentileri arasında bilgi, yeterli iletişim, emosyonel destek ve bakım gelmektedir. [2] Kanser tanı ve tedavisi zorlu bir süreçtir ve bu süreçte hastalar ile sağlık profesyonelleri arasında iletişim problemleri yaşanabilmektedir. [3] Oysa sağlık profesyonelleri ile hasta arasındaki iletişimin yetersiz olması tedavi ile ilgili karar GirişKanser yaşamı önemli ölçüde etkileyen, zor bir hastalıktır.

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“…consultation), female patients with female oncologists were more likely to encourage empathic responses from clinicians [17]. Emotion-related quality of life of cancer patients has also been indicated as a predictor influencing the discussion around emotion during consultations [14]. There is little evidence showing how HNC patients' emotional wellbeing might relate to the dynamics of emotional discussion with their clinicians.…”

Section: Introductionmentioning

confidence: 99%

“…In the United Kingdom, the National Institute for Clinical Excellence (NICE) guidelines recommended that the psychosocial issues are routinely assessed and discussed in oncology practice [7]. Despite recognised patient benefits, national efforts and many communication training programmes [8,9], research evidence suggests a continued prevalence of unaddressed psychological issues among cancer patients [10][11][12][13][14]. It is, therefore, important to intricately investigate factors influencing oncologists' positive responses to patients' negative emotions in routine oncology practice.…”

Section: Introductionmentioning

confidence: 99%

How head and neck consultants manage patients' emotional distress during cancer follow-up consultations: a multilevel study

2015

Br Dent J

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Abstract:Objectives: Head and neck cancer (HNC) patients suffer substantial emotional problems. This study aimed to explore how utterance-level variables (source, type and timing of emotional cues) and patient-level variables (e.g. age, gender and emotional wellbeing) relate to consultants' responses (i.e. reducing or providing space) to patient expressions of emotional distress.Methods: Forty-three HNC outpatient follow-up consultations were audio recorded and coded, for patients' expressions of emotional distress and consultants' responses, using the Verona Coding Definitions of Emotional Sequence (VR-CoDES). Multilevel logistic regression modelled the probability of the occurrence of consultant reduce space response as a function of patient distress cue expression, controlling for consultation and patient-related variables.Results: An average of 3.5 cues/concerns (range 1-20) was identified per consultation where 84 out of 152 total cues/concerns were responded by reducing space. Cue type did not impact on response; likewise for the quality of patient emotional wellbeing. However, consultants were more likely to reduce space to cues elicited by patients, as opposed to those initiated by themselves. This reduce space response was more pronounced as the consultation continued. However, about six minutes into the consultation, this effect (i.e. tendency to block patients) started to weaken.Conclusions: Head and neck consultants' responses to negative emotions depended on source and timing of patient emotional expressions. The findings are useful for training programme development to encourage consultants to be more flexible and open in the early stages of the consultation.

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Discussion of emotional and social impact of cancer during outpatient oncology consultations

Abstract: Low prevalence of discussion of psychosocial issues cannot be accounted for by patient or clinician communication preferences. If clinicians rely on patients to initiate discussion of psychosocial issues, patients' problems may go unaddressed.

Cited by 56 publications

References 24 publications

Interprofessional Communication Skills Training for Serious Illness: Evaluation of a Small-Group, Simulated Patient Intervention

Interprofessional Communication Skills Training for Serious Illness: Evaluation of a Small-Group, Simulated Patient Intervention

Investigation of Cancer Patients’ Information Sources, Information Needs and Expectations of Health Professionals

How head and neck consultants manage patients' emotional distress during cancer follow-up consultations: a multilevel study

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