Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T08:03:48.844Z Has data issue: false hasContentIssue false
  • English
  • Français

Development and preliminary evaluation of communication skills training program for oncologists based on patient preferences for communicating bad news

Published online by Cambridge University Press:  04 November 2013

Maiko Fujimori ,
Yuki Shirai ,
Mariko Asai ,
Nobuya Akizuki ,
Noriyuki Katsumata ,
Kaoru Kubota  and
Yosuke Uchitomi
Maiko Fujimori
Affiliation:
Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan Psycho-Oncology Division, National Cancer Center Hospital, Chuoh-ku, Tokyo, Japan
Yuki Shirai
Affiliation:
Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan Department of Adult Nursing and Palliative Care Nursing, University of Tokyo, Bunkyo-ku, Tokyo, Japan
Mariko Asai
Affiliation:
Graduate School of Clinical Psychology, Teikyo Heisei University, Toshima-ku, Tokyo, Japan
Nobuya Akizuki
Affiliation:
Department of Psycho-oncology, Chiba Cancer Center, Chuo-ku, Chiba, Japan
Noriyuki Katsumata
Affiliation:
Department of Medical Oncology, Nippon Medical School, Musashikosugi Hospital, Nakahara-ku, Kawasaki, Kanagawa, Japan
Kaoru Kubota
Affiliation:
Medical Oncology Division, Nippon Medical School Hospital, Bunkyo-ku, Tokyo, Japan
Yosuke Uchitomi*
Affiliation:
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
*
Address correspondence and reprint requests to: Yosuke Uchitomi, Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. E-mail: uchitomi@okayama-u.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The purposes of this study were to develop a communication skills training (CST) workshop program based on patient preferences, and to evaluate preliminary feasibility of the CST program on the objective performances of physicians and the subjective ratings of their confidence about the communication with patients at the pre- and post-CST.

Methods:

The CST program was developed, based on the previous surveys on patient preferences (setting up the supporting environment of the interview, making consideration for how to deliver bad news, discussing about additional information, and provision of reassurance and emotional support) and addressing the patient's emotion with empathic responses, and stressing the oncologists' emotional support. The program was participants' centered approach, consisted a didactic lecture, role plays with simulated patients, discussions and an ice-breaking; a total of 2-days. To evaluate feasibility of the newly developed CST program, oncologists who participated it were assessed their communication performances (behaviors and utterances) during simulated consultation at the pre- and post-CST. Participants also rated their confidence communicating with patients at the pre-, post-, and 3-months after CST, burnout at pre and 3 months after CST, and the helpfulness of the program at post-CST.

Results:

Sixteen oncologists attended a newly developed CST. A comparison of pre-post measures showed improvement of oncologists' communication performances, especially skills of emotional support and consideration for how to deliver information. Their confidence in communicating bad news was rated higher score at post-CST than at pre-CST and was persisted at 3-months after the CST. Emotional exhaustion scores decreased at 3-months after CST. In addition, oncologists rated high satisfaction with all components of the program.

Significance of results:

This pilot study suggests that the newly developed CST program based on patient preferences seemed feasible and potentially effective on improving oncologists' communication behaviors what patients prefer and confidence in communicating with patients.

Keywords

Communication skills trainingPatients' preferenceBad newsPatient-physician relationship
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 5 , October 2014 , pp. 379 - 386
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Back, A.L., Arnold, R.M., Baile, W.F., et al. (2007). Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Archives of Internal Medicine, 167, 453–460.Google Scholar
Baile, F.W., Lenzi, R., Kudelka, A.P., et al. (1997). Improving physician-patient communication in cancer care: outcome of a workshop for oncologists. Journal of Cancer Education, 12, 166–173.Google Scholar
Baile, W.F., Kudelka, A.P., Beale, E.A., et al. (1999). Communication skills training in oncology. Description and preliminary outcomes of workshops on breaking bad news and managing patient reactions to illness. Cancer, 86, 887–897.Google Scholar
Baile, W.F., Buckman, R., Lenzi, R., et al. (2000). SPIKES-A six-step protocol for delivering bad news: Application to the patient with cancer. Oncologist, 5, 302–311.Google Scholar
Butow, P.N., Kazemi, J.N., Beeney, L.J., et al. (1996). When the diagnosis is cancer: patient communication experiences and preferences. Cancer, 77, 2630–2637.Google Scholar
Cegala, D.J. & Lenzmeier Broz, S. (2002), Physician communication skills training: A review of theoretical backgrounds, objectives and skills. Medical Education, 36, 1004–1016.CrossRefGoogle ScholarPubMed
Fallowfield, L., Jenkins, V., Farewell, V., et al. (2002). Efficacy of a cancer research UK communication skills training model for oncologists: A randomised controlled trial. Lancet, 359, 650–656.Google Scholar
Fellowes, D., Wilkinson, S. & Moore, P. (2004). Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database System Review, 2, CD003751.Google Scholar
Fujimori, M., Oba, A., Koike, M., et al. (2003). Communication skills training for Japanese oncologists on how to break bad news. Journal of Cancer Education, 18, 194–201.Google Scholar
Fujimori, M., Akechi, T., Akizuki, N., et al. (2005). Good communication with patients receiving bad news about cancer in Japan. Psychooncology, 14, 1043–1051.CrossRefGoogle ScholarPubMed
Fujimori, M., Akechi, T., Morita, T., et al. (2007). Preferences of cancer patients regarding the disclosure of bad news. Psychooncology, 16, 573–581.CrossRefGoogle ScholarPubMed
Fujimori, M. & Uchitomi, Y. (2009). Preferences of cancer patients regarding communication of bad news: A systematic literature review. Japanese Journal of Clinical Oncology, 39, 201–216.Google Scholar
Girgis, A., Sanson-Fisher, R. & Schofield, M.J. (1999). Is there consensus between breast cancer patients and providers on guidelines for breaking bad news? Journal of Behavioral Medicine, 25, 69–77.Google Scholar
Higashiguchi, K., Morikawa, Y., Miura, K., et al. (1998). The development of the Japanese version of the Maslach burnout inventory and the examination of the factor structure. Nippon Eiseigaku Zassi, 53, 447–555(in Japanese).Google Scholar
Ishikawa, H., Takayama, T., Yamazaki, Y., et al. (2002). The interaction between physician and patient communication behaviors in Japanese cancer consultations and the influence of personal and consultation characteristics. Patient Education and Counseling, 46, 277–285.Google Scholar
Jenkins, V. & Fallowfield, L. (2002). Can communication skills training alter physicians' beliefs and behavior in clinics? Journal of Clinical Oncology, 20, 765–769.Google Scholar
Lenzi, R., Baile, W.F., Costantini, A., et al. (2010). Communication training in oncology: Results of intensive communication workshops for Italian oncologists. European Journal of Cancer Care, 20, 196–203.Google Scholar
Maslach, C. & Jackson, S. (1986). Maslach Burnout Inventory. Palo Alto: Consulting Psychologist's Press.Google Scholar
Morita, T., Akechi, T., Ikenaga, M., et al. (2004). Communication about the ending of anticancer treatment and transition to palliative care. Annals of Oncology; 15, 1551–1557.Google Scholar
Parker, P.A., Baile, W.F., de Moor, C., et al. (2001). Breaking bad news about cancer: patients' preferences for communication. Journal of Clinical Oncology, 19, 2049–2056.Google Scholar
Ramirez, A.J., Graham, J., Richards, M.A., et al. (1995). Burnout and psychiatric disorder among cancer clinicians. British Journal of Cancer, 71, 1263–1269.Google Scholar
Roter, D.L., Hall, J.A., Kern, D.E., et al. (1995). Improving physicians' interviewing skills and reducing patients' emotional distress. Randomized clinical trial. Achieve of Intern Medicine, 155, 1877–1884.Google Scholar
Schofield, P.E., Butow, P.N., Thompson, J.F., et al. (2003). Psychological responses of patients receiving a diagnosis of cancer. Annual of Oncology, 14, 48–56.Google Scholar
Shilling, V., Jenkins, V. & Fallowfield, L. (2003). Factors affecting patient and clinician satisfaction with the clinical consultation: Can communication skills training for clinicians improve satisfaction? Psychooncology, 12, 599–611.CrossRefGoogle ScholarPubMed
Uchitomi, Y., Mikami, I., Kugaya, A., et al. (2001). Physician support and patient psychologic responses after surgery for nonsmall cell lung carcinoma: A prospective observational study. Cancer, 92, 1926–1935.Google Scholar