This study is aimed at evaluating the effectiveness of a physician-centered communication skills training program on cancer patient anxiety levels.
Methods and Study design
In this quasi-experimental study, physicians from 9 units of 5 general hospitals and 1 cancer research institute were recruited. The unit heads chose which physicians would attend the training program (treatment group) and which would not (control group). The effectiveness of the course was evaluated by assessing the evolution of state anxiety in a sample of cancer patients before and after clinical consultations.
Results
Thirty-eight physicians and 339 outpatients were assessed. Patients from the treatment and control groups did not differ in pre-examination anxiety or psychological distress levels. Patients examined by physicians from the treatment group displayed a higher decrease in state-anxiety levels compared with those examined by physicians from the control group. A higher proportion of high anxiety levels was found in women, in less educated patients, and in those with a high distress level.
Conclusions
Our findings suggest the effectiveness of the communication skills training program with reference to patient anxiety levels. Given the potential gap between training and clinical impact, further studies investigating the effect of communication training on patient outcomes are needed.
StarkD.P., HouseA.Anxiety in cancer patients. Br J Cancer.2000; 83(10): 1261–1267.
2.
van der MolenB.Relating information needs to the cancer experience: 1. Information as a key coping strategy. Eur J Cancer Care (Engl).1999; 8(4): 238–244.
3.
LeydonG.M., BoultonM., MoynihanC.. Cancer patients' information needs and information seeking behaviour: in depth interview study. BMJ.2000; 320(7239): 909–913.
4.
GattellariM., VoigtK.J., ButowP.N., TattersallM.H.When the treatment goal is not cure: are cancer patients equipped to make informed decisions?J Clin Oncol.2002; 20(2): 503–513.
5.
MaguireP., FaulknerA., BoothK., ElliottC., HillierV.Helping cancer patients disclose their concerns. Eur J Cancer.1996; 32A(1): 78–81.
6.
ButowP.N., BrownR.F., CogarS., TattersallM.H., DunnS.M.Oncologists' reactions to cancer patients' verbal cues. Psychooncology.2002; 11(1): 47–58.
7.
DonovanJ.L., BlakeD.R.Qualitative study of interpretation of reassurance among patients attending rheumatology clinics: “just a touch of arthritis, doctor?”. BMJ.2000; 320(7234): 541–544.
8.
StarkD., KielyM., SmithA., MorleyS., SelbyP., HouseA.Reassurance and the anxious cancer patient. Br J Cancer.2004; 91(5): 893–899.
9.
OngL.M., de HaesJ.C., HoosA.M., LammesF.B.Doctor-patient communication: a review of the literature. Soc Sci Med.1995; 40(7): 903–918.
10.
GyselsM., RichardsonA., HigginsonI.J.Communication training for health professionals who care for patients with cancer: a systematic review of training methods. Support Care Cancer.2005; 13(6): 356–366.
11.
BerkhofM., van RijssenH.J., SchellartA.J.M., AnemaJ.R., van der BeekA.J.Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews. Patient Educ Couns.2011; 84(2): 152–162.
12.
GyselsM., RichardsonA., HigginsonI.J.Communication training for health professionals who care for patients with cancer: a systematic review of effectiveness. Support Care Cancer.2004; 12(10): 692–700.
13.
BarthJ., LannenP.Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis. Ann Oncol.2011; 22(5): 1030–1040.
14.
LiénardA., MerckaertI., LibertY.. Factors that influence cancer patients' anxiety following a medical consultation: impact of a communication skills training programme for physicians. Ann Oncol.2006; 17(9): 1450–1458.
15.
ShillingV., JenkinsV., FallowfieldL.Factors affecting patient and clinician satisfaction with the clinical consultation: can communication skills training for clinicians improve satisfaction?Psychooncology.2003; 12(6): 599–611.
16.
StewartM., BrownJ.B., HammertonJ.. Improving communication between doctors and breast cancer patients. Ann Fam Med.2007; 5(5): 387–394.
17.
WilkinsonS., PerryR., BlanchardK., LinsellL.Effectiveness of a three-day communication skills course in changing nurses' communication skills with cancer/palliative care patients: a randomised controlled trial. Palliat Med.2008; 22(4): 365–375.
18.
PaulC.L., Clinton-McHargT., Sanson-FisherR.W., DouglasH., WebbG.Are we there yet? The state of the evidence base for guidelines on breaking bad news to cancer patients. Eur J Cancer.2009; 45(17): 2960–2966.
19.
UitterhoeveR.J., BensingJ.M., GrolR.P., DemulderP.H.M., VAN AchterbergT.The effect of communication skills training on patient outcomes in cancer care: a systematic review of the literature. Eur J Cancer Care (Engl).2010; 19(4): 442–457.
20.
LenziR., BaileW.F., CostantiniA., GrassiL., ParkerP.A.Communication training in oncology: results of intensive communication workshops for Italian oncologists. Eur J Cancer Care (Engl).2011; 20(2): 196–203.
21.
MorassoG., CostantiniM., BaraccoG., BorreaniC., CapelliM.Assessing psychological distress in cancer patients: validation of a self-administered questionnaire. Oncology.1996; 53(4): 295–302.
22.
SpielbergerC.D., GorsuchR.L., LusheneR.E., VaggP.R., JacobsG.A.State-trait anxiety inventory for adults.Palo Alto: Mind Garden, 1983.
SPSS Inc. SPSS 13.0 base user's guide.Chicago: SPSS Inc, 2004.
25.
HeckR.H., ThomasS.L., TabataL.N.Multilevel and longitudinal modeling with IBM SPSS.New York: Taylor & Francis Group, 2010.
26.
HarderV.S., StuartE.A., AnthonyJ.C.Propensity score techniques and the assessment of measured covariate balance to test causal associations in psychological research. Psychol Methods.2010; 15(3): 234–249.
27.
VodermaierA., LindenW., MacKenzieR., GreigD., MarshallC.Disease stage predicts post-diagnosis anxiety and depression only in some types of cancer. Br J Cancer.2011; 105(12): 1814–1817.
28.
LindenW., VodermaierA., MackenzieR., GreigD.Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord.2012; 141(2-3): 343–351.
29.
FellowesD., WilkinsonS., MooreP.Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database Syst Rev.2004; 2: CD003751.
30.
OtaniH., MoritaT., EsakiT.. Burden on oncologists when communicating the discontinuation of anticancer treatment. Jpn J Clin Oncol.2011; 41(8): 999–1006.
