Good communication skills may be key to improved patient satisfaction
HOUSTON -- Oncologists who learn how to communicate bad news and better handle patients' emotional reactions may improve their patients' quality of life, according to physicians at The University of Texas M. D. Anderson Cancer Center.
The results of communication skills training for oncologists are published in the Sept. 1 issue of Cancer.
According to Dr. Walter F. Baile, chief of the Section of Psychiatry at M. D. Anderson and lead author, doctors who possess good communication skills have better relationships with their patients, and their patients have a higher rate of satisfaction, often independent of the outcome of the disease. One key to an improved doctor/patient relationship, he added, is the doctor's ability to break bad news compassionately and assist patients in coping with their illness.
"Oncologists naturally focus on technological solutions to medical problems," said Dr. Baile. "Patients with serious illness, however, also benefit by knowing the truth about their disease and their options rather than by being given false hope. And yet many medical students never hear a lecture on how to effectively communicate bad news to patients."
During two half-day workshops, 27 M. D. Anderson faculty members met in groups for didactic presentations and then broke into small groups where they used role-play and discussion to problem-solve difficult cases from their practices. The workshops were evaluated by means of a follow-up satisfaction questionnaire and also a self-efficacy measure. The surveys showed that, as a result of the training, participants felt more confident about their ability to react appropriately in stressful patient interactions.
Dr. Andrzej Kudelka, associate professor of gynecologic medical therapeutics at M. D. Anderson and one of the study researchers, attributes the workshop's success to a step-by-step approach, which is analogous to other medical procedures.
"Patients often feel overwhelmed by the nature and amount of information provided to them. Information is taken in better when its amount and timing is tailored to the patients' need at the time. This is very similar to the approach we take in the dosing and timing of medication administration. Communications training gives doctors the skill and confidence to do this," he said.
The protocol for breaking bad news is described in the current report. An upcoming corresponding study by the same team of researchers is surveying 500 cancer patients at M. D. Anderson about their information and communication preferences when doctors must disclose distressing information.
8/30/99
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