Improving communication with oncology patients: Taping the consultation

Deutsch, G.P.

doi:10.1016/s0936-6555(05)80774-5

Cited by 38 publications

(28 citation statements)

References 5 publications

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“…The acceptability and efficacy of audiotapes as aids to memory and well-being were tested in a consecutive series of patients attending a medical oncology clinic, to whom potentially distressing clinical information ('bad news') was being delivered. Previous studies have examined the effects of audiotapes in settings limited to a single, highly motivated clinician (Hogbin and Fallowfield, 1989), a single diagnostic patient group (Lloyd et al, 1984) or the delivery of a standardised, structured set of information (North et al, 1992 Adelstein, 1991;Deutsch, 1992;Hogbin et al, 1992;Rylance. 1992).…”

Section: Methodsmentioning

confidence: 99%

The efficacy of audiotapes in promoting psychological well-being in cancer patients: a randomised, controlled trial

McHugh

Lewis²,

Ford³

et al. 1995

Br J Cancer

103

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Open or uncontrolled studies have suggested that providing cancer patients with audiotapes of their clinical interviews can improve information recall and reduce psychological distress. We tested these hypotheses in a 'clinician-blind', prospective, randomised controlled trial. A total of 117 patients newly referred to a medical oncology clinic who were to be given 'bad news' had their consultations audiotaped. Blind to the clinician, patients were randomly allocated to receive a copy of the tape to play at home or not (control group). At 6 months follow-up, tape group patients reported positive attitudes to the audiotape and were shown to recall significantly more information about their illness than did controls. Overall improvement in psychological distress at 1 and 6 months follow-up, as measured with the 30-item General Health Questionnaire and the Hospital Anxiety and Depression Scale was no different in the two groups. However, a second-order interaction suggested that poor-prognosis patients were disadvantaged specifically by access to the audiotape, with less improvement in psychological distress at 6 months follow-up than non-tape controls. Patient access to audiotapes of clinical interviews promotes factual retention but does not reliably reduce psychological distress and may be actively unhelpful in some subgroups of patients.

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Section: Methodsmentioning

confidence: 99%

The efficacy of audiotapes in promoting psychological well-being in cancer patients: a randomised, controlled trial

McHugh

Lewis²,

Ford³

et al. 1995

Br J Cancer

103

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“…[129][130][131][132][133][134][135] Parents frequently consult others in making health care decisions for their children, ranging from extended family members to other practitioners, other parents, religious leaders, and tribal elders. One study found that tapes made during outpatient encounters were listened to by parents nearly universally; grandparents listened to them more than half the time (52.8%), 70% were listened to more than once, and one third of parents made a copy to keep for themselves.…”

Section: Audiotapes As Communication Aidsmentioning

confidence: 99%

Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information

Levetown¹

2008

Pediatrics

404

296

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Health care communication is a skill that is critical to safe and effective medical practice; it can and must be taught. Communication skill influences patient disclosure, treatment adherence and outcome, adaptation to illness, and bereavement. This article provides a review of the evidence regarding clinical communication in the pediatric setting, covering the spectrum from outpatient primary care consultation to death notification, and provides practical suggestions to improve communication with patients and families, enabling more effective, efficient, and empathic pediatric health care. INTRODUCTION/OVERVIEWHealth care communication is a critical, but generally neglected, component of pediatric and pediatric subspecialty practice and training and is a skill that can and must be taught. [1][2][3][4][5][6][7][8][9][10][11][12][13] The practicing clinician's ability to communicate openly and with compassion is essential for effective and efficient routine health care; this ability becomes a vital lifeline for parents and children confronted with lifealtering and sometimes life-ending conditions. [13][14][15][16] The purpose of this report is to provide research-based and practical guidance to enable effective communication with pediatric patients and their families in a number of common settings and situations. Although child abuse, sexuality, divorce, and many other situations are not individually addressed, the principles and approaches discussed apply equally to these situations.Communication is the most common "procedure" in medicine. Health care communication is different from normal social discourse, because intimate and very private issues are often discussed. These include hopes and fears, developmental concerns, sexuality, and mental health disorders. Painful issues, such as abuse, school failure, drug use, and terminal illness, are also discussed. Communication is the foundation of the therapeutic relationship; it is the basis of fiduciary and ethical obligations of physicians to patients and their families. Effective health care communication is an essential tool for accurate diagnosis [17][18][19] and for the development of a successful treatment plan, 20-23 correlating with improved patient knowledge, 15,24 functional status, 25,26 adherence to the agreed-on treatment regimen, 20,21,27-32 improved psychological and behavioral outcomes, 15,33-36 and even reduced surgical morbidity. 3,4,37 In the case of distressing news, skillful communication can enable a family to adapt better to a challenging situation, 12,38,39 including a child's unanticipated impairments. [40][41][42][43] Poor communication, on the other hand, can prompt lifelong anger 31,42,44-48 and regret, 14,40 can result in compromised outcomes for the patient and family, and can have medicolegal consequences for the practitioner. 49

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“…A large majority of cancer patients are in favour of receiving summary letters or consultation audiotapes (Deutsch, 1992;Tattersall et al, 1994;McHugh et al, 1995). Moreover, in randomized controlled trials, the provision of either a letter or tape has been shown to increase patients' overall satisfaction with their medical consultation (Damian and Tattersall, 1991;Dunn et al, 1993), recall and understanding (Hogbin and Fallowfield, 1989;McHugh et al, 1995) and patient activity in the consultation.…”

mentioning

confidence: 99%

Audiotapes and letters to patients: the practice and views of oncologists, surgeons and general practitioners

1999

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Summary A range of measures have been proposed to enhance the provision of information to cancer patients and randomized controlled trials have demonstrated their impact on patient satisfaction and recall. The current study explored the practice and views of oncologists, surgeons and general practitioners (GPs) with regards to providing patients with consultation audiotapes and summary letters. In stage 1, 28 semi-structured interviews with doctors were conducted to provide qualitative data on which to base a questionnaire. In stage 2, 113 medical oncologists, 43 radiation oncologists, 55 surgeons and 108 GPs completed questionnaires. Only one-third of doctors had ever provided patients with a copy of the letter written to the oncologist or referring doctor, and one-quarter had provided a summary letter or tape. The majority of doctors were opposed to such measures; however, a substantial minority were in favour of providing a letter or tape under certain conditions. More surgeons and GPs (> two-thirds) were opposed to specialists providing a consultation audiotape than oncologists (onethird). Gender, years of experience and attitude to patient involvement in decision-making were predictive of doctors' attitudes. The majority of doctors remain opposed to offering patients personalized information aids. However, practice and perspectives appear to be changing.

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Improving communication with oncology patients: Taping the consultation

Cited by 38 publications

References 5 publications

The efficacy of audiotapes in promoting psychological well-being in cancer patients: a randomised, controlled trial

The efficacy of audiotapes in promoting psychological well-being in cancer patients: a randomised, controlled trial

Communicating With Children and Families: From Everyday Interactions to Skill in Conveying Distressing Information

Audiotapes and letters to patients: the practice and views of oncologists, surgeons and general practitioners

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