Oncologists’ experience with discussing cancer prognosis with patients and families: perspectives from India

2021 ◽  
Author(s):  
Sravannthi Maya ◽  
Smita C Banerjee ◽  
Shweta Chawak ◽  
Patricia A Parker ◽  
Sreekanth Kandikattu ◽  
...  
Keyword(s):  
Communication Skills ◽  
Interpretative Phenomenological Analysis ◽  
Skills Training ◽  
Cancer Prognosis ◽  
System Level ◽  
Communication Skills Training ◽  
Structured Interviews ◽  
Open Communication ◽  
Patients With Cancer ◽  
Empathic Communication

Abstract Nondisclosure of prognosis of advanced cancer is commonly practiced in some Asian cultures including India; but research is limited. To describe experiences of Indian oncologists in discussing cancer prognosis with people with cancer and their caregivers, with a focus on barriers and facilitators of prognostic discussions. Thirty oncologists practicing in South India, Hyderabad participated in semi-structured interviews; and analyzed using Interpretative Phenomenological Analysis. Barriers included system-level, patient-level, and physician-level challenges as obstructions to open and honest interactions around cancer prognosis. Most of the barriers focused on communication-related challenges. Lack of communication skills training for providers coupled with over-reliance on use of euphemisms, hesitation in communicating with “weak” patient, and struggles to establish healthcare proxy described communication-related barriers. The study also described factors including family involvement in cancer care and empathic communication as facilitators of honest and open communication about prognosis. In particular, rapport building and getting to know the patient, use of empathic communication, engaging in gradual and individualized disclosure, and balancing hope with honesty were communication-related facilitators that aid open communication with patients with cancer and their caregivers about prognosis and plan of care. Results provide implications for development of communication skills trainings for oncology physicians in India. Adapting, delivering, and evaluating existing communication skills training programs, particularly around discussions of prognosis and goals of care is a requisite step for providing patient-centered and supportive care to patients with cancer and their caregiving families.

scholarly journals A Virtual Counseling Application Using Artificial Intelligence for Communication Skills Training in Nursing Education: Development Study (Preprint)

2019 ◽  
Author(s):  
Shefaly Shorey ◽  
Emily Ang ◽  
John Yap ◽  
Esperanza Debby Ng ◽  
Siew Tiang Lau ◽  
...  
Keyword(s):  
Health Care ◽  
Nursing Students ◽  
Communication Skills ◽  
Family Members ◽  
Real Life ◽  
Skills Training ◽  
Communication Skills Training ◽  
Open Communication ◽  
The Creation ◽  
Virtual Counseling

BACKGROUND The ability of nursing undergraduates to communicate effectively with health care providers, patients, and their family members is crucial to their nursing professions as these can affect patient outcomes. However, the traditional use of didactic lectures for communication skills training is ineffective, and the use of standardized patients is not time- or cost-effective. Given the abilities of virtual patients (VPs) to simulate interactive and authentic clinical scenarios in secured environments with unlimited training attempts, a virtual counseling application is an ideal platform for nursing students to hone their communication skills before their clinical postings. OBJECTIVE The aim of this study was to develop and test the use of VPs to better prepare nursing undergraduates for communicating with real-life patients, their family members, and other health care professionals during their clinical postings. METHODS The stages of the creation of VPs included preparation, design, and development, followed by a testing phase before the official implementation. An initial voice chatbot was trained using a natural language processing engine, Google Cloud’s Dialogflow, and was later visualized into a three-dimensional (3D) avatar form using Unity 3D. RESULTS The VPs included four case scenarios that were congruent with the nursing undergraduates’ semesters’ learning objectives: (1) assessing the pain experienced by a pregnant woman, (2) taking the history of a depressed patient, (3) escalating a bleeding episode of a postoperative patient to a physician, and (4) showing empathy to a stressed-out fellow final-year nursing student. Challenges arose in terms of content development, technological limitations, and expectations management, which can be resolved by contingency planning, open communication, constant program updates, refinement, and training. CONCLUSIONS The creation of VPs to assist in nursing students’ communication skills training may provide authentic learning environments that enhance students’ perceived self-efficacy and confidence in effective communication skills. However, given the infancy stage of this project, further refinement and constant enhancements are needed to train the VPs to simulate real-life conversations before the official implementation.

Communication Skills Training for Professionals Working with Adolescent Patients with Cancer Based on Participants' Needs: A Pilot

2019 ◽  
Vol 8 (3) ◽  
pp. 354-362 ◽  
Author(s):  
Stefan Essig ◽  
Claudia Steiner ◽  
Thomas Kühne ◽  
Bernhard Kremens ◽  
Wolf Langewitz ◽  
...  
Keyword(s):  
Communication Skills ◽  
Skills Training ◽  
Communication Skills Training ◽  
Patients With Cancer ◽  
Adolescent Patients

scholarly journals Responding empathically to patients: a communication skills training module to reduce lung cancer stigma

2020 ◽  
Author(s):  
Smita C Banerjee ◽  
Noshin Haque ◽  
Carma L Bylund ◽  
Megan J Shen ◽  
Maureen Rigney ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Communication Skills ◽  
Self Efficacy ◽  
Skills Training ◽  
Pulmonary Medicine ◽  
Communication Skills Training ◽  
Training Module ◽  
Lung Cancer Patients ◽  
Empathic Communication

Abstract Most lung cancer patients report perceiving stigma surrounding their diagnosis, and routine clinical interactions with their health care providers (HCPs) are reported as a common source. The adverse effects of lung cancer stigma are associated with several adverse psychosocial and behavioral outcomes. One potential clinician-level intervention target is empathic communication because of its association with higher rates of patients’ satisfaction, treatment adherence, and lower levels of psychological distress. This study describes the conceptual model and evaluation of clinician-targeted empathic communication skills training to reduce lung cancer patients’ experience of stigma. The goal of the training module is to enhance clinician recognition and responsiveness to lung cancer patients’ empathic opportunities by communicating understanding, reducing stigma and distress, and providing support. Thirty multidisciplinary HCPs working in thoracic oncology, thoracic surgery, or pulmonary medicine participated in 2.25 hr of didactic and experiential training on responding empathically to patients with lung cancer. Overall, participants reported highly favorable evaluations of the training, with at least 90% of participants agreeing or strongly agreeing to 11 of the 12 items assessing clinical relevance, novelty, clarity, and facilitator effectiveness. Participants’ self-efficacy to communicate empathically with lung cancer patients increased significantly from pretraining to posttraining, t(29) = −4.58, p < .001. The empathic communication skills training module was feasible and well received by thoracic and pulmonary medicine HCPs and demonstrated improvements in self-efficacy in empathic communication from pretraining to posttraining. The examination of patient outcomes is warranted.

scholarly journals A Virtual Counseling Application Using Artificial Intelligence for Communication Skills Training in Nursing Education: Development Study

10.2196/14658 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e14658 ◽  
Author(s):  
Shefaly Shorey ◽  
Emily Ang ◽  
John Yap ◽  
Esperanza Debby Ng ◽  
Siew Tiang Lau ◽  
...  
Keyword(s):  
Health Care ◽  
Nursing Students ◽  
Communication Skills ◽  
Family Members ◽  
Real Life ◽  
Skills Training ◽  
Communication Skills Training ◽  
Open Communication ◽  
The Creation ◽  
Virtual Counseling

Background The ability of nursing undergraduates to communicate effectively with health care providers, patients, and their family members is crucial to their nursing professions as these can affect patient outcomes. However, the traditional use of didactic lectures for communication skills training is ineffective, and the use of standardized patients is not time- or cost-effective. Given the abilities of virtual patients (VPs) to simulate interactive and authentic clinical scenarios in secured environments with unlimited training attempts, a virtual counseling application is an ideal platform for nursing students to hone their communication skills before their clinical postings. Objective The aim of this study was to develop and test the use of VPs to better prepare nursing undergraduates for communicating with real-life patients, their family members, and other health care professionals during their clinical postings. Methods The stages of the creation of VPs included preparation, design, and development, followed by a testing phase before the official implementation. An initial voice chatbot was trained using a natural language processing engine, Google Cloud’s Dialogflow, and was later visualized into a three-dimensional (3D) avatar form using Unity 3D. Results The VPs included four case scenarios that were congruent with the nursing undergraduates’ semesters’ learning objectives: (1) assessing the pain experienced by a pregnant woman, (2) taking the history of a depressed patient, (3) escalating a bleeding episode of a postoperative patient to a physician, and (4) showing empathy to a stressed-out fellow final-year nursing student. Challenges arose in terms of content development, technological limitations, and expectations management, which can be resolved by contingency planning, open communication, constant program updates, refinement, and training. Conclusions The creation of VPs to assist in nursing students’ communication skills training may provide authentic learning environments that enhance students’ perceived self-efficacy and confidence in effective communication skills. However, given the infancy stage of this project, further refinement and constant enhancements are needed to train the VPs to simulate real-life conversations before the official implementation.

scholarly journals Confidence in communicating with patients with cancer mediates the relationship between rehabilitation therapists’ autistic-like traits and perceived difficulty in communication

2018 ◽  
Vol 17 (2) ◽  
pp. 186-194
Author(s):  
Chinatsu Hayashibara ◽  
Masatoshi Inagaki ◽  
Maiko Fujimori ◽  
Yuji Higuchi ◽  
Masaki Fujiwara ◽  
...  
Keyword(s):  
Communication Skills ◽  
Short Form ◽  
Skills Training ◽  
Autism Spectrum ◽  
Communication Styles ◽  
Autism Spectrum Quotient ◽  
Communication Skills Training ◽  
Patients With Cancer ◽  
Communication Difficulties ◽  
The Relationship

AbstractObjectiveRecently, rehabilitation therapists have become involved in cancer rehabilitation; however, no communication skills training that increases the ability to provide emotional support for cancer patients has been developed for rehabilitation therapists. In addition, no study has examined associations between rehabilitation therapists’ communication skills and their level of autistic-like traits (ALT), which are in-born characteristics including specific communication styles and difficulty communicating with patients. In this study, we aimed to investigate whether confidence in communicating with patients mitigates communication difficulties experienced by rehabilitation therapists who have high levels of ALT.MethodRehabilitation therapists who treat patients with cancer completed self-administered postal questionnaires anonymously. Scores were obtained on the Autism-Spectrum Quotient short form, confidence in communication, and communication difficulties. We used covariance structure analyses to test hypothetical models, and confirmed that confidence in communication mediates the relationship between ALT and perceived communication difficulties.ResultsParticipants included 1,343 respondents (49.6%). Autism-Spectrum Quotient scores were positively correlated with communication difficulties (r = 0.16, p < 0.001). The correlation was mitigated by confidence in communication in the fit model. However, higher confidence in creating a supportive atmosphere was associated with more difficulty in communication (r = 0.16, p < 0.001).Significance of resultsCommunication difficulty was linked to rehabilitation therapists’ ALTs. By increasing confidence in areas of communication other than creation of a supportive atmosphere, ALT-related difficulties in communication may be ameliorated. Confidence to create supportive environments correlated positively with difficulty. Communication skills training to increase confidence in communication for rehabilitation therapists should be developed with vigilance regarding ALT levels.

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