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Responding to patient anger: Development and evaluation of an oncology communication skills training module

Published online by Cambridge University Press:  22 November 2011

Philip A. Bialer*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
David Kissane
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
Richard Brown
Affiliation:
Department of Social and Behavioral Health, Virginia Commonwealth University School of Medicine, Richmond, Virginia
Tomer Levin
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
Carma Bylund
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
*
Address correspondence and reprint requests to: Philip A. Bialer, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY 10022. E-mail: bialerp@mskcc.org

Abstract

Objective:

The purpose of this study was to develop a communication skills training (CST) module for oncology healthcare professionals on how to more effectively respond to patient anger. We also sought to evaluate the module in terms of participant self-efficacy and satisfaction.

Method:

The development of this module was based on a systematic review of the literature and followed the Comskil model previously used for other doctor–patient CST. Using an anonymous 5-point Likert scale, participants rated their pre-post self-efficacy in responding to patient anger as well as their satisfaction with the course. Data were analyzed using a paired sample t test.

Results:

During the academic years 2006–2009, 275 oncology healthcare professionals participated in a CST that focused on responding to patient anger. Participants' confidence in responding to patient anger increased significantly (p < 0.001) after attending the workshop. They also agreed or strongly agreed to five out of six items assessing course satisfaction 92–97% of the time.

Significance of results:

We have developed a CST module on how to respond to patient anger, which is both effective and useful. Training healthcare professionals to respond more effectively to patient anger may have a positive impact on the patient–physician relationship.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

REFERENCES

Brown, R. & Bylund, C. (2008). Communication skills training: Describing a new conceptual model. Academic Medicine, 83, 3744.CrossRefGoogle ScholarPubMed
Brown, R., Bylund, C.L., Lubrano di Ciccone, B., et al. (2010). Patient centered communicaton skills for oncologists: describing the content and efficacy of training. Communication Education, 59, 235248.CrossRefGoogle Scholar
Bylund, C., Brown, R., di Ciccone, B., et al. (2008). Training faculty to facilitate communication skills training: Development and evaluation of a workshop. Patient Education and Counseling, 70, 430436.CrossRefGoogle ScholarPubMed
Bylund, C., Brown, R., Gueguen, J., et al. (2010). The implementation and assessment of a comprehensive communication skills training curriculum for oncologists. Psycho-Oncology, 19, 583593.CrossRefGoogle ScholarPubMed
Bylund, C. & Makoul, G. (2005). Examining empathy in medical encounters: An observational study using the empathic communication coding system. Health Communication, 18, 123140.CrossRefGoogle ScholarPubMed
Cegala, D.J. & Broz, S.L. (2002). Physician communication skills training: A review of the theoretical backgrounds, objectives and skills. Medical Education, 36, 10041016.CrossRefGoogle ScholarPubMed
Essary, A. & Symington, S. (2005). How to make the “difficult” patient encounter less difficult. JAAPA, 18, 4954.CrossRefGoogle Scholar
Fallowfield, L., Lipkin, M. & Hall, A. (1998). Teaching senior oncologists communication skills: Results from phase I of a comprehensive longitudinal program in the United Kingdom. Journal of Clinical Oncology, 16, 19611968.CrossRefGoogle ScholarPubMed
Groves, J.E. (1978). Taking care of the hateful patient. New England Journal of Medicine, 298, 883887.CrossRefGoogle ScholarPubMed
Gysels, M., Richardson, A. & Higginson, I. (2004). Communication training for health professionals who care for patients with cancer: A systematic review of effectiveness. Supportive Care in Cancer, 12, 692700.CrossRefGoogle Scholar
Hahn, S.R., Kroenke, K., Spitzer, R.L., et al. (1996). The difficult patient: Prevalence, psychopathology, and functional impairment. Journal of General Internal Medicine, 11, 18.CrossRefGoogle ScholarPubMed
Hill, L.G. (2005). Revisiting the retrospective pretest. American Journal of Evaluation, 26, 501517.CrossRefGoogle Scholar
Jenkins, V., Fallowfield, L. & Saul, J. (2001). Information needs of patients with cancer: Results from a large study in UK cancer centres. British Journal of Cancer, 84, 4851.CrossRefGoogle ScholarPubMed
Kissane, D.W. (1994). Managing anger in palliative care. Australian Family Physician, 23, 12571259.Google ScholarPubMed
Kissane, D.W., Bloch, S., Burns, W.I., et al. (1994). Psychological morbidity in the families of patients with cancer. Psycho-Oncology, 3, 4756.CrossRefGoogle Scholar
Knowles, M.S. (1978). The Adult Learner: A Negelcted Species. Houston: Gulf.Google Scholar
Lown, B. (2007). Difficult conversations: Anger in the clinician–patient/family relationship. Southern Medical Journal, 100, 3339.CrossRefGoogle ScholarPubMed
Pearce, C. (2002). The difficult patient. Australian Family Physician, 31, 177178, 181.Google ScholarPubMed
Ramirez, A., Richards, M., Potts, H.W.W., et al. (2005). Changes in mental health of UK hospital consultants since the mid-1990s. The Lancet, 366, 742744.Google Scholar
Ramirez, A.J., Graham, J., Richards, M.A., et al. (1996). Mental health of hospital consultants: The effects of stress and satisfaction at work. The Lancet, 347, 724728.CrossRefGoogle ScholarPubMed
Sloan, D.A., Donnelly, M.B., Schwartz, R.W., et al. (1995). The Objective Structured Clinical Examination. The new gold standard for evaluating postgraduate clinical performance. Annals of Surgery, 222, 735742.CrossRefGoogle ScholarPubMed
Stefanek, M.E., Derogatis, L.P. & Shaw, A. (1987). Psychological distress among oncology outpatients. Prevalence and severity as measured with the Brief Symptom Inventory. Psychosomatics, 28, 530532, 537.CrossRefGoogle ScholarPubMed
Steinmetz, D. & Tabenkin, H. (2001). The “difficult patient” as perceived by family physicians. Family Practice, 18, 495500.CrossRefGoogle Scholar
Stiefel, F., Favre, N. & Despland, J.N. (2006). Communication skills training in oncology: It works! Recent Results in Cancer Research, 168, 113119.CrossRefGoogle ScholarPubMed