Communication as a Part of the Supportive Treatment in Cancer Care

Česká verzia

Authors: V. Bencová
Authors place of work: I. onkologická klinika LF UK a Onkologický ústav sv. Alžbety, Bratislava
Published in the journal: Klin Onkol 2013; 26(3): 195-200
Category: Original Articles

Summary

Background:
Interpersonal communication skills as part of the supportive care in cancer won new dimensions by demonstrating the association with enhanced ability of patients to cope with the disease, to enhance trust in health care providers, compliance with treatment and to reduce emotional distress and psychosocial burden. Besides empathy the effective patient‑ centered communication is based upon perceptual and behavioral skills of caregivers. Doctors, nurses, and oncology social workers have to achieve skills to listen to patient’s complains and to respond to his/ her support needs. The aim of the present paper was to perform a meta‑analysis of published data dealing with principles and methods of the assertive doctor‑ patient communication within the supportive care of patients suffering from emotional and social dysfunctions.

Material and methods:
The data of interpersonal communication skills in oncology presented in the current literature were collected using electronic databases and were elaborated in form of meta‑analysis of 24 selected publications.

Results:
Active behavioral approach involves the understanding of the non‑verbal indications of patient’s needs, preferences, and expectations, the evaluation of patient’s non‑verbal expression of fear, uncertainty, irritability, depression and apathy or even the unwillingness to disclose his/ her concerns. Recognizing these and other concerns (marital and sexual problems, physical and cognitive functioning etc.), caregivers should respond these concerns in verbal form of psychosocial support. Skills in the interpersonal communication can be learned by clinical experience and theoretical preparation.

Conclusion:
Developing the communication skills including the perception and behavioral style is particularly important in clinician’s early medical teaching. The implementation of communication skills into undergraduate and postgraduate study programs in medicine, nursing, and other paramedical subjects is still in infancy, although the professional communication with cancer patient and its family members is associated with clear and important outcomes of care approved by clinical research and recognized by cancer professionals.

Key words:
cancer – psychosocial burden – supportive care – communication – principles – otcomes – education

Zdroje

1. Vorlíček J, Adam Z, Pospíšilová Y. Paliativní medicína. 2. vyd. Praha: Grada‑ Avicenum 2004: 537.

2. Wilkinson AV, Barrera SL, McBride CM et al. Exact health behaviors and uptake of standardized vs. tailored health messages among cancer survivors enrolled in the fresh start trial: a comparison of fighting spirits vs. fatalists. Psychooncology 2012; 21(1): 108– 113.

3. Epstein RM, Street RL. Patient‑ centered communication in cancer care. Promoting healing and reducing suffering. National Cancer Institute. Bethesda (MD, USA): NIH Publ. 2007. Available from: http:/ / www.outcomes.cancer.gov/ areas/ pcc/ communication.

4. Janáčková L, Weiss P. Komunikace ve zdravotnické péči. 1. vyd. Praha: Portál 2008: 136.

5. Bencova V, Bella J, Svec J. Psychosocial morbidity and psychosocial support needs of breast cancer survivors one and three years after breast‑ conserving surgery. Psychooncology 2011; 20 (Suppl 2): 112– 113.

6. Brédart A, Bouleuc C, Dolbeault S. Doctor‑ patient communication and satisfaction with care in oncology. Curr Opin Oncol 2005; 17(4): 351– 354.

7. Baile WF, Aaron J. Patient‑ physician communication in oncology: past, present, and future. Curr Opin Oncol 2005. 17(4): 331– 335.

8. Epstein RM, Franks P, Fiscella K et al. Measuring patient‑ centered communication in patient‑ physician consultation: theoretical and practical issues. Soc Sci Med 2005; 61(7): 1516– 1528.

9. Krupat E, Rosenkranz SL, Yeager CM et al. The practice orientation of physicians and patients: the effect of doctor‑ patients congruence on satisfaction. Patient Educ Couns 2000; 39(1): 49– 59.

10. Street RL. Communicative styles and adaptation in physician‑ patient consultation. Soc Sci Med 1992; 34(10): 1155– 1163.

11. Zachariae R, Pedersen CG, Jensen AB et al. Association of percieved physician communication style with patient satisfaction, distress, cancer‑related self efficaty, and percieved control over the disease. Br J Cancer 2003; 88(5): 658– 665.

12. Brown RF, Butow PN, Henman M et al. Responding to the active and passive patient: flexibility is the key. Health Expect 2002; 5(3): 236– 245.

13. Parchman ML, Burge SK. The patient‑ physician relationship, primary care attributes and preventive services. Fam Med 2004; 36(1): 22– 27.

14. Beach MC, Roter DL. Interpersonal expectations in the patient‑ physician relationship. J Gen Intern Med 2000; 15(11): 825– 827.

15. Marvel MK, Epstein RM, Flowers K et al. Soliciting the patient’s agenda: have we improved? JAMA 1999; 281(3): 283– 287.

16. Hall JA, Hogan TG, Stein TS et al. Living in the physician‑ patient relationship. Patient Educ Cons 2002; 48(1): 69– 77.

17. Fallowfield L, Jenkins V, Farewell V et al. Enduring impact of communication skills training: results of a 12- month follow‑up. Br J Cancer 2003; 89(8): 1445– 1449.

18. Merckaert I, Libert Y, Razavi D. Communication skill training in cancer care: where we are and where are we going? Curr Opin Oncol 2005; 17(4): 319– 330.

19. Venglářová M, Mahrová G. Komunikace pro zdravotní sestry. 1. vyd. Praha: Grada Publishing 2006: 144.

20. Teutsch C. Patient‑ doctor communication. Med Clin North Am 2003; 87(5): 1115– 1145. Available from: http:/ / www.ncbi.nlm.nih.gov/ pubmed/ 14621334

21. Sibille K, Greene A, Bush JP. Preparing physicians for the 21 century: Communicating skills and the promotion of health behavior change. Ann Behav Sci Med Educ 2010; 16(1): 7– 13.

22. Davis TC, Williams MV, Marin E et al. Health literacy and cancer communication. CA Cancer J Clin 2002; 52(3): 134– 149.

23. Bruera E, Willey JS, Palmer JL et al. Treatment decisions of breast carcinoma: patients preferences and physician perceptions. Cancer 2002; 94(7): 2076– 2080.

24. Okamura H, Uchitomi Y, Sasako M et al. Guidelines for telling the truth to cancer patients. Jpn J Clin Oncol 1998; 28(1): 1–4.

25. Bencova V, Mrazova A, Svec J. Psychosocial morbidity – an unfilled gap in undergraduate courses of medicine and nursing. Clin Social Work 2010; 1– 2: 37– 46.