Education and counselling for cancer patients--lifting the shroud of silence

Teaching patients to speak up: past and future trends

The patient role as discussed in popular and professional literature is in a transitional period, but actual patient behaviors remain predominantly traditional. This article summarizes advice to the public concerning patient-physician communication from the past 25 years of popular periodicals and recent self-help literature. The few extant programs for improving patient communication skills are identified. Recommendations are made for more extensive patient-focused education and research regarding skills development and behavior change.

Cancer patient education: reality and potential

Cancer now attacks one in three Americans, resulting in one in six deaths. Yet, until recently, few patient education programs were directed toward cancer patients. This review examines the status of cancer patient education and suggests future directions. We focus on several aspects of cancer patient education, including needs assessments and programs in treatment, rehabilitation, and continuing care and evaluation. The most comprehensive patient education programs are those directed toward patients in active treatment; one of its tasks is to help patients manage treatment side effects. A major component of rehabilitation programs is counseling patients to help them cope with the effects of cancer. Many patient education programs have performed evaluations; most reflect difficulties in one or more areas, such as selecting appropriate measures or accruing adequate sample sizes. We recommend several directions for the future, including the use of appropriate measurement tools, adequate sample sizes, multimodality programs with incorporation of psychological techniques such as relaxation training and guided imagery, and assessment of the impact of patient education programs on costs.

Patient education in general practice: opinions of general practitioners

Fifty-two general practitioners were interviewed regarding their task in patient education and various aspects of it. The view general practitioners have on patient education is complex. Although they consider it a central task, the range of methods they are willing to use is limited. Many general practitioners tend to overlook the fact that they are not the only source of information and explanation for patients. They would prefer to keep control over information given patients, fearing that patients might be confused. It is notable that many general practitioners have no clear standards of what patients need to know. Much depends on the questions the individual patient asks. There are several kinds of information that general practitioners are disinclined to give, particularly relating to uncertainties or information that might alarm the patient. The outlook for improvement must not be overestimated. Some directions are given for supporting the development of patient education.

Social networks and health status: linking theory, research, and practice

Social support and social networks are among the psychosocial influences of physical and mental wellbeing. This literature review attempts to link the theory, research, and practice relevant to social networks and their association with health status. It is necessary that we extend our intervention strategies to build upon and collaborate with the individual and collective expertise of social networks.