Maiko Fujimori, Yuki Shirai, Mariko Asai, and Yosuke Uchitomi, National Cancer Center Hospital East, Kashiwa; Maiko Fujimori, National Cancer Center Hospital and National Institute of Mental Health, National Center for Neurology and Psychiatry; Yuki Shirai, University of Tokyo; Mariko Asai, Teikyo Heisei University; Kaoru Kubota, Nippon Medical School, Tokyo; Noriyuki Katsumata, Nippon Medical School, Musashikosugi Hospital, Kawasaki; and Yosuke Uchitomi, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
J Clin Oncol. 2014 Jul 10;32(20):2166-72. doi: 10.1200/JCO.2013.51.2756. Epub 2014 Jun 9.
The aim of this study was to identify the effects of a communication skills training (CST) program for oncologists, developed based on patient preferences regarding oncologists' communication.
Thirty oncologists were randomly assigned to either an intervention group (IG; 2-day CST workshop) or control group (CG). Participants were assessed on their communication performance during simulated consultation and their confidence in communicating with patients at baseline and follow-up. A total of 1,192 patients (response rate, 84.6%) who had consultations with the participating oncologists at baseline and/or follow-up were assessed regarding their distress using the Hospital Anxiety and Depression Scale, satisfaction with the consultation, and trust in their oncologist after the consultation.
At the follow-up survey, the performance scores of the IG had improved significantly, in terms of their emotional support (P = .011), setting up a supportive environment (P = .002), and ability to deliver information (P = .001), compared with those of the CG. Oncologists in the IG were rated higher at follow-up than those in the CG in terms of their confidence in themselves (P = .001). Patients who met with oncologists after they had undergone the CST were significantly less depressed than those who met with oncologists in the CG (P = .027). However, the CST program did not affect patient satisfaction with oncologists' style of communication.
A CST program based on patient preferences is effective for both oncologists and patients with cancer. Oncologists should consider CST as an approach to enhancing their communication skills.
本研究旨在确定一种基于患者对肿瘤医生沟通偏好的沟通技巧培训(CST)计划对肿瘤医生的影响。
30 名肿瘤医生被随机分配到干预组(IG;为期 2 天的 CST 研讨会)或对照组(CG)。在基线和随访时,通过模拟咨询评估参与者的沟通表现及其与患者沟通的信心。共有 1192 名患者(响应率为 84.6%)在基线和/或随访时与参加的肿瘤医生进行了咨询,使用医院焦虑和抑郁量表评估他们的痛苦、对咨询的满意度以及对肿瘤医生的信任。
在随访调查中,IG 的表现评分在情感支持(P=0.011)、营造支持性环境(P=0.002)和传递信息能力(P=0.001)方面与 CG 相比有显著提高。与 CG 相比,IG 中的肿瘤医生在随访时对自己的信心评分更高(P=0.001)。接受 CST 后与肿瘤医生见面的患者比 CG 中与肿瘤医生见面的患者抑郁程度显著降低(P=0.027)。然而,CST 计划并没有影响患者对肿瘤医生沟通方式的满意度。
基于患者偏好的 CST 计划对肿瘤医生和癌症患者都有效。肿瘤医生应考虑 CST 作为提高沟通技巧的一种方法。