Departments of Medical Psychology.
Departments of Medical Psychology.
Ann Oncol. 2014 Apr;25(4):896-901. doi: 10.1093/annonc/mdu027. Epub 2014 Mar 10.
Cancer patients need to trust their oncologist to embark in the process of oncologic treatment. Yet, it is unclear how oncologist communication contributes to such trust. The aim of this study was to investigate the effect of three elements of oncologists' communication on cancer patients' trust: conferring competence, honesty, and caring.
Eight videotaped consultations, 'vignettes', were created, reflecting an encounter between an oncologist and a patient with colorectal cancer. All vignettes were identical, except for small variations in the oncologist's verbal communication. Cancer patients (n = 345) were randomly assigned to viewing two vignettes, asked to identify with the patient and afterwards to rate their trust in the observed oncologist. The effects of competence, honesty, and caring on trust were established with multilevel analysis.
Oncologist's enhanced expression of competence (β = 0.17, 95% CI 0.08, 0.27; P < 0.001), honesty (β = 0.30, 95% CI 0.20, 0.40; P < 0.001), as well as caring (β = 0.36, 95% CI 0.26, 0.46; P < 0.001) resulted in significantly increased trust. Communication of honesty and caring also increased patients' expectation of operation success and reported willingness to recommend the oncologist.
CONCLUSION(S): As hypothesized, oncologists can influence their patients' trust by enhanced conveyance of their level of competence, honesty, and caring. Caring behavior has the strongest impact on trust. These findings can be translated directly into daily clinical practice as well as in communication skills training.
癌症患者需要信任他们的肿瘤医生，才能开始肿瘤治疗。然而，目前尚不清楚肿瘤医生的沟通方式如何促进这种信任。本研究旨在调查肿瘤医生沟通的三个要素（传达能力、诚实和关怀）对癌症患者信任的影响。
创建了 8 个视频咨询“情景”，反映了肿瘤医生和结直肠癌患者之间的一次会面。所有情景都是相同的，只是肿瘤医生的口头沟通略有不同。随机分配 345 名癌症患者观看两个情景，要求他们认同患者的角色，然后对观察到的肿瘤医生的信任程度进行评分。采用多水平分析确定能力、诚实和关怀对信任的影响。
肿瘤医生增强表达能力（β=0.17，95%置信区间 0.08，0.27；P<0.001）、诚实（β=0.30，95%置信区间 0.20，0.40；P<0.001）和关怀（β=0.36，95%置信区间 0.26，0.46；P<0.001）会显著增加信任。诚实和关怀的沟通也会增加患者对手术成功的期望，并报告更愿意推荐该肿瘤医生。
正如假设的那样，肿瘤医生可以通过增强传达其能力、诚实和关怀水平来影响患者的信任。关怀行为对信任的影响最大。这些发现可以直接转化为日常临床实践以及沟通技巧培训。
