Experiences of Nurse Practitioners in Communicating Bad News to Cancer Patients

General and Unique Communication Skills Challenges for Advanced Practice Providers: A Mixed-Methods Study

AIMS

Advanced practice providers are a rapidly growing sector of the health-care field. Despite their relatively new place in the medical establishment, these providers are held to high standards of education, practice, and communication skills. However, the communication needs of these practitioners are somewhat different than those of nurses or physicians. These skills are even more necessary in specialized fields where providers frequently are involved in discussions of prognosis, goals of care, and end of life.

DESIGN

This was a mixed-methods study.

METHODS

We completed a needs assessment of communication skills for advanced practice providers at a large cancer center in the northeastern United States from June to July 2017.

RESULTS

Participants were confident in their skills across several areas of communication, but also endorsed the need for communication skills training, particularly for challenging interactions with patients and families. Advanced practice providers described many challenges similar to those descried by other health-care providers, including general communication skills problems, navigating team dynamics, and goals-of-care planning. However, participants also endorsed communication skills needs specific to their field, including certain patient-centered challenges, perceived/real limitations of their role, serving as the "middleman," and understanding the advanced practice provider's role.

CONCLUSION

Given the general and unique communication challenges advanced practice providers in oncology face, we conclude with recommendations for further institutional and educational changes to better address these needs.

Instruments for assessing health professionals' skills in breaking bad news: protocol for a systematic review of measurement properties

INTRODUCTION

Health professionals are often involved in the process of breaking bad news (BBN), which remains a difficult challenge, as it requires not only theoretical knowledge, but also the development of humanistic, emotional and communication skills. Therefore, optimal BBN assessment is essential. In this regard, sound measurement instruments are needed to evaluate BBN properly in research, teaching and clinical settings. Several instruments have been designed and validated to assess BBN. In this context, choosing the most appropriate instrument for assessing health professionals' skills in BBN is essential. The aims of this systematic review are to: (1) identify all the instruments used for assessing health professionals' skills in BBN; and (2) critically appraise their measurement properties.

METHODS

A systematic review will be undertaken according to the most up-to-date COnsensus-based Standards for the selection of health status Measurement INstruments' (COSMIN) methodology. The protocol of this systematic review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy will be performed following the Peer Review of Electronic Search Strategies. The search strategy will be conducted in CINAHL, MEDLINE, Embase, PsycINFO, SciELO and Open Grey. Two review authors will independently appraise the full-text articles according to the COSMIN Risk of Bias checklist. Quality ratings and evidence synthesis will be performed using a modified Grading of Recommendations Assessment, Development and Evaluation approach.

ETHICS AND DISSEMINATION

Ethical approval is not necessary for systematic review protocols. The results will be disseminated by publication in a peer-reviewed journal and presented at a relevant conference.

PROSPERO REGISTRATION NUMBER

CRD42020207586.