Enrolment in clinical trials

Author(s):  
Richard F. Brown ◽  
Terrance Albrecht

Cancer clinical trials are conducted to progress the efficacy of cancer treatments. The success of such clinical trials is dependent on enrolling cancer patients. However, enrolments rates remain low, and lower participation rates are reported in minority patients. The goal of this chapter is to outline issues involved in recruitment to clinical trials and to describe the ethical principles underlying informed consent. A model of communication skills training is presented to provide suggested strategies to aid communication between healthcare providers and patients about clinical trials. The programme involves training in shared decision-making, information flow, and the disclosure of information. The results of a pilot programme utilizing this model and skills are also presented.

Author(s):  
Anthony De La Cruz ◽  
Richard F. Brown ◽  
Steve Passik

Depression is a common occurrence among cancer patients; however, it goes undetected by healthcare providers in about 50% of cases. Ambulatory nurses are in a key position to identify and respond to a patient’s emotional distress and aid in the detection of patients at risk for or suffering from depression. Programmes in communication skills training have been shown to help nurses detect and respond to patient depression. A model of core communication components consisting of strategies, skills, and process tasks is presented. This model will enable nurses to gain an understanding of the patient’s experience and assist in the recognition and treatment of depression. The results of a pilot programme utilizing this model and skills will also be presented. An overview of the nature of depression and risks factors and barriers to the identification of depression is presented.


2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 80-80 ◽  
Author(s):  
Ruth Manna ◽  
Smita C. Banerjee ◽  
Megan Johnson Shen ◽  
Beatriz Korc-Grodzicki ◽  
Yesne Alici ◽  
...  

80 Background: Medical decision-making is the process of shared understanding of a patient’s personal values and subsequent negotiation to reach a treatment decision. Discussing options and engaging patients in decision-making remains a challenge for many clinicians. The challenge is greater when treating older patients, who may be cognitively impaired, and may have family members or caregivers playing significant roles in their care. The geriatric communication skills training (CST) guides clinicians in effectively communicating with older cancer patients and their caregivers around pivotal cancer care decisions. Methods: A multidisciplinary team from a Comprehensive Cancer Center collaborated on the development of a one-day training program, consisting of three geriatric specific CST modules: Geriatrics 101, Cognitive Syndromes and Shared Decision Making. Each module included a brief didactic (30 min) with exemplary videos, followed by experiential role play (90 min) with standardized patients (SP), co-led by multi-disciplinary facilitators. These sessions were video recorded to enable reflective learning, group discussion, and feedback. We examined preliminary efficacy of the intervention on multiple outcomes, including participant course evaluations, self-efficacy and coded SP assessments. Results: 28 clinicians, including mental health professionals, oncologists, family practitioners, physician assistants, nurse practitioners, and social workers participated in the training. All participants reported strong satisfaction results with the workshop. Self-efficacy ratings increased significantly across all three modules, t(21) = -4.58, p < .001 between pre-training (M = 3.39, SD = .66) and post-training (M = 4.13, SD = .59). In SP assessments, participants also demonstrated significant uptake of agenda setting skills and increased responsiveness to caregiver concerns from pre to post training. Conclusions: The geriatric CST program was well received and demonstrated improvements in knowledge. Interdisciplinary training groups present for excellent case discussion and modeling opportunities for a variety of communication challenges.


MedEdPORTAL ◽  
2015 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Rock ◽  
Nina Gadmer ◽  
Robert Arnold ◽  
David Roberts ◽  
Asha Anandaiah ◽  
...  

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