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Communication skills training for medical residents: Enhancing a psychosocial approach of patient care. Palliat Support Care 2022; 21:392-398. [PMID: 35256039 DOI: 10.1017/s147895152200030x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES One of the issues that has increasingly become relevant to medical practice is the ability to communicate well with patients. Better communication results in better care for the patient, as well as greater satisfaction for the physician. For this reason, the aim of this study was to assess the efficacy of a communication skills training program for medical residents (MR). METHOD Eighty-six MR underwent a 6-month training program in three phases: a 12-h theory and practice workshop, a period of real practice, and a 4-h workshop in which the most challenging scenarios were role played with an actress. In each phase (T0, T1, and T2), participants' beliefs about their competence in caring for patients' psychosocial aspects and their self-confidence in communication skills were assessed. RESULTS No differences were found between T0 and T1 in participants' beliefs of self-competence in psychosocial care. However, this competence significantly improved after completion of the entire program. Only 7 of the 12 areas explored in communication skills significantly improved between T0 and T1. However, after T2 completion, significant improvements were observed in all 12 areas. SIGNIFICANCE OF RESULTS The research results highlight the usefulness and importance of training young doctors to foster their psychosocial approach to patient care and improve their confidence in their own communication skills. The results also show the appropriateness of the structure of the training: the key features of the programme were the follow-up of the participants in three phases over 6 months, and a focus on the needs of the residents and the resolution of difficult clinical cases, with the support of an actress. Therefore, the training presented in this study may become a guide for other trainings in other contexts with similar objectives.
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Fischer F, Helmer S, Rogge A, Arraras JI, Buchholz A, Hannawa A, Horneber M, Kiss A, Rose M, Söllner W, Stein B, Weis J, Schofield P, Witt CM. Outcomes and outcome measures used in evaluation of communication training in oncology - a systematic literature review, an expert workshop, and recommendations for future research. BMC Cancer 2019; 19:808. [PMID: 31412805 PMCID: PMC6694634 DOI: 10.1186/s12885-019-6022-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 08/06/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Communication between health care provider and patients in oncology presents challenges. Communication skills training have been frequently developed to address those. Given the complexity of communication training, the choice of outcomes and outcome measures to assess its effectiveness is important. The aim of this paper is to 1) perform a systematic review on outcomes and outcome measures used in evaluations of communication training, 2) discuss specific challenges and 3) provide recommendations for the selection of outcomes in future studies. METHODS To identify studies and reviews reporting on the evaluation of communication training for health care professionals in oncology, we searched seven databases (Ovid MEDLINE, CENTRAL, CINAHL, EMBASE, PsychINFO, PsychARTICLES and Web of Science). We extracted outcomes assessed and the respective assessment methods. We held a two-day workshop with experts (n = 16) in communication theory, development and evaluation of generic or cancer-specific communication training and/or outcome measure development to identify and address challenges in the evaluation of communication training in oncology. After the workshop, participants contributed to the development of recommendations addressing those challenges. RESULTS Out of 2181 references, we included 96 publications (33 RCTs, 2 RCT protocols, 4 controlled trials, 36 uncontrolled studies, 21 reviews) in the review. Most frequently used outcomes were participants' training evaluation, their communication confidence, observed communication skills and patients' overall satisfaction and anxiety. Outcomes were assessed using questionnaires for participants (57.3%), patients (36.0%) and observations of real (34.7%) and simulated (30.7%) patient encounters. Outcomes and outcome measures varied widely across studies. Experts agreed that outcomes need to be precisely defined and linked with explicit learning objectives of the training. Furthermore, outcomes should be assessed as broadly as possible on different levels (health care professional, patient and interaction level). CONCLUSIONS Measuring the effects of training programmes aimed at improving health care professionals' communication skills presents considerable challenges. Outcomes as well as outcome measures differ widely across studies. We recommended to link outcome assessment to specific learning objectives and to assess outcomes as broadly as possible.
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Affiliation(s)
- F. Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - S. Helmer
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - A. Rogge
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - J. I. Arraras
- Radiotherapeutic Oncology Department & Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - A. Buchholz
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre, Hamburg, Germany
| | - A. Hannawa
- Center for the Advancement of Healthcare Quality and Patient Safety (CAHQS), Faculty of Communication Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - M. Horneber
- Department of Internal Medicine, Divisions of Pneumology and Oncology/Hematology, Paracelsus Medical University, Klinikum Nuernberg, Nuernberg, Germany
| | - A. Kiss
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - M. Rose
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Quantitative Health Sciences, Outcomes Measurement Science, University of Massachusetts Medical School, Worcester, USA
| | - W. Söllner
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - B. Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - J. Weis
- Comprehensive Cancer Center, Department of Self-Help Research, Faculty of Medicine and Medical Center University of Freiburg, Freiburg, Germany
| | - P. Schofield
- Department of Psychology, Swinburne University, Melbourne, Victoria Australia
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria Australia
| | - C. M. Witt
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD USA
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Micheli A, Sanz N, Mwangi-Powell F, Coleman MP, Neal C, Ullrich A, Travado L, Santini LA, Grassi L, De Lorenzo F, Costa A, Dangou JM, Bisanti L, Costantini AS, Abu-Rmeileh N, Kamal M, Federico M, Saracci R, Rennert G, Stefanini A, Cavalli F, Cazap E, Redmond K, O?Reilly S, Muti P, Casali P, Gatta G, Ferrari A, Koifman S, Bah E, Pastore G, Barr R, Lombardo C, Frazzingaro C, Ciampichini R, Baili P. International collaborations in cancer control and the Third International Cancer Control Congress. TUMORI JOURNAL 2018; 95:579-96. [DOI: 10.1177/030089160909500502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the past few decades, there has been growing support for the idea that cancer needs an interdisciplinary approach. Therefore, the international cancer community has developed several strategies as outlined in the WHO non-communicable diseases Action Plan (which includes cancer control) as the World Health Assembly and the UICC World Cancer Declaration, which both include primary prevention, early diagnosis, treatment, and palliative care. This paper highlights experiences/ideas in cancer control for international collaborations between low, middle, and high income countries, including collaborations between the European Union (EU) and African Union (AU) Member States, the Latin-American and Caribbean countries, and the Eastern Mediterranean countries. These proposals are presented within the context of the global vision on cancer control set forth by WHO in partnership with the International Union Against Cancer (UICC), in addition to issues that should be considered for collaborations at the global level: cancer survival (similar to the project CONCORD), cancer control for youth and adaptation of Clinical Practice Guidelines. Since cancer control is given lower priority on the health agenda of low and middle income countries and is less represented in global health efforts in those countries, EU and AU cancer stakeholders are working to put cancer control on the agenda of the EU-AU treaty for collaborations, and are proposing to consider palliative care, population-based cancer registration, and training and education focusing on primary prevention as core tools. A Community of Practice, such as the Third International Cancer Control Congress (ICCC-3), is an ideal place to share new proposals, learn from other experiences, and formulate new ideas. The aim of the ICCC-3 is to foster new international collaborations to promote cancer control actions in low and middle income countries. The development of supranational collaborations has been hindered by the fact that cancer control is not part of the objectives of the Millennium Development Goals (MGGs). As a consequence, less resources of development aids are allocated to control NCDs including cancer.
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Affiliation(s)
- Andrea Micheli
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Natalia Sanz
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Michel P Coleman
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Andreas Ullrich
- Diseases and Health Promotion, World Health Organization (WHO), Geneva, Switzerland
| | - Luzia Travado
- National Coordination for Oncology Diseases, High Commission for Health, Lisbon, Portugal
| | | | - Luigi Grassi
- Section of Psychiatry, University of Ferrara, Italy
| | | | | | | | - Luigi Bisanti
- Epidemiology Unit, Local Health Authority of Milan, Milan, Italy
| | - Adele Seniori Costantini
- Occupational and Environmental Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Niveen Abu-Rmeileh
- Institute of Community and Public Health, Birzeit University West Bank, Palestinian Authority
| | - Mostafa Kamal
- Egyptian Smoking Prevention Research Institute, Cairo, Egypt
| | | | | | - Gad Rennert
- National Israeli Breast and Colorectal Cancer Detection Programs Ministry of Health and Israel Cancer Association, Department of Community Medicine and Epidemiology Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion, Israel
| | - Angelo Stefanini
- Office of Development Cooperation, Consulate General of Italy, Jerusalem (on leave from the University of Bologna, Italy), Jerusalem, Israel
| | - Franco Cavalli
- International Union Against Cancer (UICC), Geneva, Switzerland
| | - Eduardo Cazap
- Latino American and Caribbean Society of Medical Oncology (SLACOM), Buenos Aires, Argentina
| | - Kathy Redmond
- Cancer World Magazine and Media Program, European School of Oncology, Milan, Italy
| | - Susan O?Reilly
- British Columbia Cancer Agency, Division of Medical Oncology Department of Medicine at the University of British Columbia, Vancouver, Canada
| | - Paola Muti
- Italian National Cancer Institute “Regina Elena”, Rome, Italy
| | - Paolo Casali
- Oncology Medicine Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Gemma Gatta
- Evaluation Epidemiology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Andrea Ferrari
- Paedriatic Oncology Unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | | | - Ebrima Bah
- International Agency for Cancer Research (IARC), Banjul, Gambia
| | | | | | - Claudio Lombardo
- National Institute for Cancer Research of Genoa, Genoa, and Alleanza Contro il Cancro, Rome
| | - Cristina Frazzingaro
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Roberta Ciampichini
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
| | - Paolo Baili
- Descriptive studies and health planning unit, Fondazione IRCCS “Istituto Nazionale dei Tumori”, Milan, Italy
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Core communication components along the cancer care process: The perspective of breast cancer patients. Breast 2014; 23:617-22. [DOI: 10.1016/j.breast.2014.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 04/25/2014] [Accepted: 06/05/2014] [Indexed: 12/30/2022] Open
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Abstract
AbstractObjective:Doctor–patient communication in oncology, particularly concerning diagnostic disclosure, is a crucial factor related to the quality of the doctor–patient relationship and the psychological state of the patient. The aims of our study were to investigate physicians' opinions and practice with respect to disclosure of a cancer diagnosis and to explore potential related factors.Method:A self-report questionnaire developed for our study was responded to by 120 physicians from Coimbra University Hospital Centre and its primary healthcare units.Results:Some 91.7% of physician respondents generally disclosed a diagnosis, and 94.2% were of the opinion that the patient knowing the truth about a diagnosis had a positive effect on the doctor–patient relationship. A need for training about communicating with oncology patients was reported by 85.8% of participants. The main factors determining what information to provide to patients were: (1) patient intellectual and cultural level, (2) patient desire to know the truth, and (3) the existence of family.Significance of results:Our results point to a paradigm shift in communication with cancer patients where disclosure of the diagnosis should be made part of general clinical practice. Nevertheless, physicians still experience difficulties in revealing cancer diagnoses to patients and often lack the skills to deal with a patient's emotional responses, which suggests that more attention needs to be focused on communication skills training programs.
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Tanzi S, Biasco G, Baile WF. Enhancing the Empathic Connection: Using Action Methods to Understand Conflicts in End-of-Life Care. J Patient Exp 2014; 1:14-19. [PMID: 28725796 DOI: 10.1177/237437431400100104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Empathy is a core feature of patient-centered care. It enables practitioners to better understand the patient and family concerns that are key to patient and family satisfaction, prevention of anxiety and depression, and provider empowerment. Current methods of teaching communication skills do not specifically focus on enhancing the ability to "stand in the patient's shoes" as a way of connecting with the patient and/or family experience and understanding feelings that may be a source of conflict with providers. In this paper, we present a model for deepening empathic understanding based upon action methods (role-reversal and doubling) derived from psychodrama and sociodrama. We describe these techniques and illustrate how they can be used to identify hidden emotions and attitudes and reveal that which the patient and family member may be thinking or feeling but be afraid to say. Finally, we present data showing that these methods were valuable to participants in enhancing their professional experience and skills.
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Affiliation(s)
- Silvia Tanzi
- Palliative Care unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Guido Biasco
- Academy of Sciences of Palliative Medicine, Bentivoglio, Bologna, Italy
| | - Walter F Baile
- Departments of Behavioral Science and Faculty and Academic Development, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Arcuri L, Montagnini B, Calvi G, Goss C. The perception of shared medical decision making of expert and lay people: effects of observing a movie clip depicting a medical consultation. PATIENT EDUCATION AND COUNSELING 2013; 91:50-55. [PMID: 23218589 DOI: 10.1016/j.pec.2012.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 10/19/2012] [Accepted: 11/06/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To test for differences between experts and lay people in assessment of the degree to which a doctor engaged in a shared decision making (SDM) with a patient using the OPTION scale and a movie clip as stimulus material. METHODS A segment of the movie 'Wit', depicting the communication of the diagnosis and the therapy proposed of a cancer, was shown to (a) university students with no knowledge about doctor-patient communication; (b) nurses working in medicine departments; (c) advanced medical students; (d) hospital physicians. The participants were asked to complete the OPTION scale which measures the extent to which physicians involve patients in medical decisions. An analysis of variance was used to compare OPTION scores across the four groups and to compare males and females. RESULTS Being female [F(1,190)=11.9; p<.001] and being familiar with medical issues [F(3,190)=11.09; p<.001] were both significantly associated with a negative evaluations of the doctor's ability to involve the patient in the SDM. CONCLUSION Lay people and males (including male experts), are less demanding regarding SDM abilities. PRACTICE IMPLICATIONS A more systematic use of videos and the OPTION scale as validated outcome measure could be helpful educational strategy for the teaching of SDM.
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Affiliation(s)
- Luciano Arcuri
- Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy.
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LENZI R, BAILE W, COSTANTINI A, GRASSI L, PARKER P. Communication training in oncology: results of intensive communication workshops for Italian oncologists. Eur J Cancer Care (Engl) 2011; 20:196-203. [DOI: 10.1111/j.1365-2354.2010.01189.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Do spirituality and faith make a difference? Report from the Southern European Psycho-Oncology Study Group. Palliat Support Care 2010; 8:405-13. [DOI: 10.1017/s147895151000026x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:In the last decade, some attention has been given to spirituality and faith and their role in cancer patients' coping. Few data are available about spirituality among cancer patients in Southern European countries, which have a big tradition of spirituality, namely, the Catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study – SEPOS), the aim of this study was to examine the effect of spirituality in molding psychosocial implications in Southern European cancer patients.Method:A convenience sample of 323 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (Karnofsky Performance Status > 80), and no cognitive deficits or central nervous system (CNS) involvement by disease were approached in university and affiliated cancer centers in Italy, Spain, Portugal, and Switzerland (Italian speaking area). Each patient was evaluated for spirituality (Visual Analog Scale 0-10), psychological morbidity (Hospital Anxiety and Depression Scale— HADS), coping strategies (Mini-Mental Adjustment to Cancer — Mini-MAC) and concerns about illness (Cancer Worries Inventory — CWI).Results. The majority of patients (79.3%) referred to being supported by their spirituality/faith throughout their illness. Significant differences were found between the spirituality and non-spirituality groups (p ≤ 0.01) in terms of education, coping styles, and psychological morbidity. Spirituality was significantly correlated with fighting spirit (r = −0.27), fatalism (r = 0.50), and avoidance (r = 0.23) coping styles and negatively correlated with education (r = −0.25), depression (r = −0.22) and HAD total (r = −0.17).Significance of results:Spirituality is frequent among Southern European cancer patients with lower education and seems to play some protective role towards psychological morbidity, specifically depression. Further studies should examine this trend in Southern European cancer patients.
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Grassi L, Travado L, Gil F, Sabato S, Rossi E, Tomamichel M, Marmai L, Biancosino B, Nanni MG. Hopelessness and Related Variables Among Cancer Patients in the Southern European Psycho-Oncology Study (SEPOS). PSYCHOSOMATICS 2010. [DOI: 10.1016/s0033-3182(10)70686-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Fukui S, Ogawa K, Fukui N. Communication skills training on how to break bad news for Japanese nurses in oncology: effects of training on nurses' confidence and perceived effectiveness. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:116-119. [PMID: 20082172 DOI: 10.1007/s13187-009-0027-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Delivering bad news is an important communication skill for oncology nurses. No Asian study has developed a communication skills training program. We investigated the effect of such a program on the confidence and practical competence of Japanese oncology nurses. Thirty-one nurses participated, based on Western work in a 6-h workshop; the effect was assessed for 3 months. We evaluated the program effect by measuring nurse-rated confidence regarding communication with patients three times (before, immediately after, and 3 months after the program), in addition to interviewing them on the perception of the program at T3. On nurse-rated confidence in communication, 16/21 items were significantly increased 3 months after the program, and almost all nurses were positive about the course effectiveness. Communication skills training increased Japanese nurses' confidence as well as being perceived as effective.
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Affiliation(s)
- Sakiko Fukui
- School of Nursing, The Japanese Red Cross University, Hiro-o 4-1-3, Shibuya-ku, Tokyo, 150-0012, Japan.
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Beyond communication: The development of a training program for hospital and hospice staff in the detection and management of psychological distress—Preliminary results. Palliat Support Care 2010; 8:27-33. [DOI: 10.1017/s1478951509990678] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:In the United Kingdom, a Four-Tier Model of Psychological Support has been recommended for all patients with cancer and their families. This model suggests that staff at Tier 2, such as nurses, doctors, and allied health professionals, should be proficient in screening for psychological distress and intervening with techniques such as psycho-education and problem solving. Research has suggested that although communication skills training is essential for staff working in cancer services, it does not necessarily improve the detection of specific psychological disorder or staff confidence in intervening with highly distressed patients. The objective was therefore to design a training program that addressed this deficit and was easily accessible to hospital staff.Method:. A training package was developed to train staff in the recommended skills. A literature review of teaching modalities and the effectiveness of different formats was conducted. A four-session program was developed, to be administered by staff at Tiers 3 and 4 of the model, such as clinical psychologists and counsellors.Results:Over 3 years, 255 sets of data were collected from staff who attended the course. Precourse, postcourse, and 6-month follow-up data were collected through the use of confidence questionnaires, developed from the literature. The data show a significant improvement in staff confidence across all domains measured, including confidence in the detection and management of psychological distress (p =.0001).Significance of results:Although the results have limitations and the data are subjective, we can conclude that this course significantly improves staff confidence in dealing with psychological distress and that this increased confidence is maintained over a 6-month follow-up period.
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Fukui S, Ogawa K, Ohtsuka M, Fukui N. Effect of communication skills training on nurses' detection of patients' distress and related factors after cancer diagnosis: a randomized study. Psychooncology 2010; 18:1156-64. [PMID: 19194993 DOI: 10.1002/pon.1429] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A randomized study was performed to investigate whether a communication skill (CS) training program can improve nurse's ability to detect the distress of patients who have just been informed of cancer diagnosis. METHODS Nurses were randomly assigned to the experimental or control group, and those in the former group had undergone CS training program. Nurses in both groups were then requested to support patients informed of their cancer diagnosis. Intervention consisted of one-on-one nurse interviews 3 times (on the day, 1 week, and 1 month after diagnosis). Patient's self-reported distress according to the Hospital Anxiety and Depression Scale and nurse's ratings of patient distress by Visual Analog Scale were assessed 3 times (1 week, 1 month, and 3 months after diagnosis). These two scales were compared between the nurses of the two groups to assess the impact of CS training. RESULTS The nurses in the experimental and control groups supported 42 and 47 patients, respectively. The analysis using mixed-effects modeling revealed no significant differences in the nurse's ability to detect patient's distress between the two groups. However, when the nurse's ratings of patient's distress and patient's self-reported distress were compared, these two scores were significantly correlated only with the nurses in the experimental group, suggesting that the nurse's ability to become aware of patient's distress had been improved in that group. CONCLUSIONS CS training for health professionals is useful in oncology practice to improve nurse's ability to recognize the distress of patients diagnosed with cancer.
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Affiliation(s)
- Sakiko Fukui
- School of Nursing, Chiba University, Chiba, Japan.
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Grassi L, Sabato S, Rossi E, Marmai L, Biancosino B. Affective syndromes and their screening in cancer patients with early and stable disease: Italian ICD-10 data and performance of the Distress Thermometer from the Southern European Psycho-Oncology Study (SEPOS). J Affect Disord 2009; 114:193-9. [PMID: 18757101 DOI: 10.1016/j.jad.2008.07.016] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Revised: 07/04/2008] [Accepted: 07/06/2008] [Indexed: 11/15/2022]
Abstract
BACKGROUND The assessment of mood and anxiety disorders secondary to cancer by using easy-to-administer instruments has been the object of recent research. METHODS The aim of this study was to examine the accuracy of the short screening tool developed by the National Comprehensive Cancer Network Clinical Practice Guidelines for Distress Management, (0-10 point-scale Distress Thermometer) (DT) in detecting affective syndrome disorders in Italian cancer patients. The sample consisted of 109 cancer outpatients who were administered the ICD-10 psychiatric interview (CIDI), the DT and the Hospital Anxiety Depression Scale (HADS). RESULTS Forty-four patients (40.4%) met the criteria for an ICD-10 diagnosis of affective syndromes. The DT was significantly associated with HADS-Total score (r=0.66, p=0.001). A cut-off > or = 4 on the DT showed a sensitivity of 79.5% and a specificity of 75.4% (positive predictive value--PPV = 68.6%; negative predictive value--NPV = 84.5%). The cut-off score > or = 10 on the HADS was associated with a sensitivity of 86% and a specificity of 81.5% (PPV = 76%; NPV = 89.9%). A cut-off score > or = 5 on DT and > or = 15 on HADS maximized sensitivity (78.6% and 85%, respectively) and specificity (83.1% and 96%, respectively) for patients with more severe affective syndromes (major depression, persistent depressive disorders). CONCLUSIONS The results suggest that simple instruments can be used as feasible tools in the screening of mood and anxiety disorders among cancer patients.
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Affiliation(s)
- Luigi Grassi
- Section of Psychiatry, Department of Medical and Surgical Sciences of Communication and Behavior, University of Ferrara, Italy.
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Travado L. Placing quality of life assessments on oncologists’ agenda. Support Care Cancer 2006; 14:979-81. [PMID: 16937121 DOI: 10.1007/s00520-006-0130-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2006] [Accepted: 07/05/2006] [Indexed: 10/24/2022]
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Gil F, Grassi L, Travado L, Tomamichel M, Gonzalez JR. Use of distress and depression thermometers to measure psychosocial morbidity among southern European cancer patients. Support Care Cancer 2005; 13:600-6. [PMID: 15761700 DOI: 10.1007/s00520-005-0780-0] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2004] [Accepted: 01/12/2005] [Indexed: 11/24/2022]
Abstract
GOALS OF WORK Recent literature has indicated the need for rapid evaluation of psychosocial issues secondary to cancer. Because of the problems of routine use of psychometric instruments, short instruments such as visual analogue scales or one-item 0-10 scales have been developed as valid assessment alternatives. PATIENTS AND METHODS A study was conducted to examine the role of two 0-10 scales in measuring emotional stress (distress thermometer, DT) and depressed mood (mood thermometer, MT), respectively, in a multicenter study carried out in southern European countries (Italy, Portugal, Spain, and Switzerland). A convenience sample of 312 cancer outpatients completed the DT and MT and the Hospital Anxiety Depression Scale (HADS). MAIN RESULTS DT was more significantly associated HADS anxiety than HADS depression while MT was related both to HADS anxiety and depression. The correlation of MT with HADS was higher than DT. A cutoff point >4 on the DT maximized sensitivity (65%) and specificity (79%) for general psychosocial morbidity while a cutoff >5 identified more severe "caseness" (sensitivity=70%; specificity=73%). On the MT, sensitivity and specificity for general psychosocial morbidity were 85% and 72% by using the cutoff score >3. A score >4 on the MT was associated with a sensitivity of 78% and a specificity of 77% in detecting more severe caseness. CONCLUSIONS Two simple instruments, the DT and the MT, were found to have acceptable levels of sensitivity and specificity in detecting psychosocial morbidity. Compared to the HADS, however, the mood MT performed better than the DT.
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Affiliation(s)
- Francisco Gil
- Psycho-Oncology Unit, Hospital Duran i Reynals, Institut Català d'Oncologia, Av. Gran Via s/n, km 2,7, 08907 L'Hospitalet, Barcelona, Spain.
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