McDarby Meghan, Mroz Emily, Walsh Leah E, Malling Charlotte, Chilov Marina, Rosa William E, Kastrinos Amanda, McConnell Kelly M, Parker Patricia A
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Psychooncology. 2025 Mar;34(3):e70108. doi: 10.1002/pon.70108.
High quality communication between individuals with cancer and their clinicians is a cornerstone of patient-centered oncology practice. Many communication skills training interventions have been evaluated to support either oncology clinicians or patients. However, there is little information regarding the scope and efficacy of combined communication interventions in oncology, or communication interventions targeting both patients and clinicians.
To systematically examine randomized controlled trials of combined communication interventions in oncology settings.
Four databases (Pubmed, Embase, PsycINFO, and Cochrane Central Register of Controlled Trials) were searched using strategies developed by an expert librarian. All years were searched through May 2024. We followed PRISMA guidelines for reporting and used the Risk of Bias 2.0 assessment tool.
The search yielded 3983 records. We assessed 52 full text articles, 13 of which were eligible (8 describing cluster randomized controlled trials, 5 describing individual randomized controlled trials). Results indicate that combined communication interventions may increase patient-centered communication in oncology settings but may be less effective in improving patient care and related outcomes.
Combined communication interventions in oncology settings and the outcomes measured to evaluate them are heterogeneous. This makes it difficult to determine the efficacy of combined communication interventions, the mechanisms by which these interventions improve patient-clinician communication as well as patient care and related outcomes, and which outcomes are most likely to be improved. Future work should clarify key targets of change for combined communication interventions and outcomes expected to be associated with patient-focused and clinician-focused intervention components.
癌症患者与其临床医生之间的高质量沟通是以患者为中心的肿瘤学实践的基石。许多沟通技能培训干预措施已被评估，以支持肿瘤学临床医生或患者。然而，关于肿瘤学中联合沟通干预措施的范围和效果，或针对患者和临床医生双方的沟通干预措施的信息很少。
系统审查肿瘤学环境中联合沟通干预措施的随机对照试验。
使用由专业图书馆员制定的策略检索四个数据库（PubMed、Embase、PsycINFO和Cochrane对照试验中央注册库）。检索了截至2024年5月的所有年份。我们遵循PRISMA报告指南，并使用偏倚风险2.0评估工具。
检索共获得3983条记录。我们评估了52篇全文文章，其中13篇符合条件（8篇描述整群随机对照试验，5篇描述个体随机对照试验）。结果表明，联合沟通干预措施可能会增加肿瘤学环境中以患者为中心的沟通，但在改善患者护理及相关结局方面可能效果较差。
肿瘤学环境中的联合沟通干预措施以及用于评估它们的测量结局具有异质性。这使得难以确定联合沟通干预措施之效果、这些干预措施改善患者与临床医生沟通以及患者护理及相关结局的机制，以及哪些结局最有可能得到改善。未来的工作应明确联合沟通干预措施的关键变革目标以及预期与以患者为重点和以临床医生为重点的干预组成部分相关的结局。
