This is not the most recent version of the article. View current version (28 MAR 2013)

Intervention Review

Communication skills training for health care professionals working with cancer patients, their families and/or carers

  1. Philippa M Moore1,*,
  2. Susie SM Wilkinson2,
  3. Solange Rivera Mercado3

Editorial Group: Cochrane Gynaecological Cancer Group

Published Online: 19 APR 2004

Assessed as up-to-date: 6 DEC 2003

DOI: 10.1002/14651858.CD003751.pub2


How to Cite

Moore PM, Wilkinson SSM, Rivera Mercado S. Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD003751. DOI: 10.1002/14651858.CD003751.pub2.

Author Information

  1. 1

    P. Universidad Catolica de Chile, Family Medicine, Santiago, Chile

  2. 2

    Marie Curie Cancer Care, Palliative Care Research and Development Unit, London, London, UK

  3. 3

    Los Condes, Av Alejandro Fleming 9840 Casa H3, Santiago, Chile

*Philippa M Moore, Family Medicine, P. Universidad Catolica de Chile, Lira 44, Santiago, Chile. moore.philippa@gmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 APR 2004

SEARCH

This is not the most recent version of the article. View current version (28 MAR 2013)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Research suggests communication skills do not reliably improve with experience. Considerable effort is dedicated to courses improving communication skills for health professionals. Evaluation of such courses is important to enable evidence-based teaching and practice.

Objectives

To assess whether communication skills training is effective in changing health professionals' behaviour in cancer care with regard to communication/interaction with patients.

Search methods

We searched CENTRAL (Cochrane Library Issue 3, 2001), MEDLINE (1966 to November 2001), EMBASE (1980 to November 2001), PsycInfo (1887 to November 2001), CINAHL (1982 to November 2001), AMED (1985 - October 2001), Dissertation Abstracts International (1861 to March 2002) and EBM Reviews (1991 to March/April 2001). Reference lists of relevant articles were searched. Three further studies were detected in November 2003.

Selection criteria

Randomized controlled trials or controlled before and after studies of communication skills training in cancer health professionals, measuring changes in behaviour/skills using objective and validated scales.

Data collection and analysis

Two reviewers independently assessed trials and extracted data.

Main results

Of 2824 references, 3 trials involving 347 health professionals were included. One provided an intensive 3 day course then assessed oncology doctors interacting with 640 patients; a second provided a modular course then assessed role plays with oncology nurses; the third was modular and assessed outcomes with clinical and simulated interviews and patient questionnaires.

In one trial, course attendees used more focused questions (probability < 0.005), focused and open questions (p = 0.005), expressions of empathy (p < 0.005) and appropriate cue responses (p < 0.05) at follow up than non-attendees. No significant differences were found between attendees and non-attendees for leading questions. From baseline to follow up, attendees had significantly different changes in rates of leading questions (p < 0.05), focused questions (p < 0.005), open questions (p < 0.05) and empathy (p = 0.005). The only observed significant difference in the second trial was that trained doctors controlled the follow-up interview more than untrained doctors (p < 0.05). Neither studies found differences in summarising, interrupting and checking. The third trial found trained nurses used more emotional speech than untrained counterparts, particularly regarding anxiety and distress. Patients interviewed by trained nurses used more emotional terms, but no differences emerged in questionnaires.

Authors' conclusions

Training programmes assessed by these trials appear to be effective in improving some areas of cancer care professionals communication skills. It is unknown whether this training would be effective if taught by others, nor the comparative efficacy of these programmes.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

More research is required to determine the usefulness of communications skills training for professionals working with cancer patients

There is some evidence to suggest labour-intensive communications skills training can have a beneficial effect on behaviour change in professionals working with cancer patients. It is not clear if this is partly due to the enthusiasm and/or skill of the facilitators and/or participants. Further research is required to assess the long-term efficacy of compulsory training, comparing different methods of training and using the awareness of patients to change as an outcome.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

對於與癌症病患、其家屬、及/或照護者共同工作之健康照護專業人員的溝通技巧訓練

研究建議,溝通技巧並不一定會隨著經驗而進步。咸已在用以改善健康照護專業人員溝通技巧之課程上投注相當心力。為能進行具有證據基礎之教學以及實施,對於此等課程之評估相當重要。

目標

評估溝通技巧訓練是否可有效改變健康照護專業人員在癌症照護上之病患溝通/互動行為。

搜尋策略

我們搜尋了CENTRAL (Cochrane Library Issue 3 2001) 、MEDLINE (1966年至2001年11月) 、EMBASE (1980年至2001年11月) 、PsycInfo (1887年至2001年11月) 、CINAHL (1982年至2001年11月) 、AMED (1985年2001年10月) 、Dissertation Abstracts International (1861年至2002年3月) 以及EBM Reviews (1991年至2001年3/4月) 。亦搜尋相關文章之參考文獻表列。在2003年11月又再偵測到3項其他研究。

選擇標準

針對癌症健康照護專業人員,使用客觀及有效之量表測量行為/技巧變化,比較溝通技巧訓練之前及之後的隨機對照試驗。

資料收集與分析

由2名回顧作者獨立評估試驗並摘錄數據。

主要結論

在2824篇參考文獻中,共收錄包括347名健康照護專業人員之3項試驗。其中第1項試驗提供密集之3天課程,接著評估與640名病患互動之腫瘤專科醫師;第2項試驗提供模組課程,接著評估腫瘤專科護士之角色扮演;第3項試驗為模組課程,並評估臨床及模擬面談者與病患問卷之結果。在第1項試驗中,在後續追蹤時,相較於非參與者,課程參與者使用了較為明確之問題 (機率 <0.005) 、明確及開放性問題 (p = 0.005) 、同理心之用語 (p <0.005) 、以及適當之線索反應 (p <0.05) 。就引導性之問題而言,參與者與非參與者間並未發現顯著之差異。由基線至後續追蹤,在引導性問題 (p <0.05) 、明確問題 (p <0.005) 、開放性問題 (p <0.05) 及同理心 (p = 0.005) 方面,參與者具有顯著之變化。在該第2項試驗中所觀察到之唯一顯著差異為經過訓練之醫師較未經訓練之醫師更能控制追蹤之面談 (p <0.05) 。並無任何一項研究發現摘述、中斷溝通、及查驗方面之差異。第3項試驗發現,經過訓練之護士較未經訓練者使用了較多的感情用語,特別是在焦慮及壓力方面。由經過訓練之護士面談之病患使用了較多的感情辭彙,但是問卷之中並未顯露差異。

作者結論

由此等試驗所評估之訓練課程似乎可以有效改善癌症健康照護專業人員溝通技巧之某些範疇。仍不知道如是由他人教授,此種訓練是否可為有效,亦不清楚此等課程之比較功效。

翻譯人

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

茲需要進一步之研究,以判定溝通技巧訓練對於與癌症病患共同工作之專業人員的有效性。部分證據建議,針對與癌症病患共同工作之專業人員,耗費人力之溝通技巧訓練對於其行為變化具有益處作用。並不清楚此種作用是否部分係因引導員及/或參與者之熱忱及/或技巧而造成。茲需要進一步之研究,比較不同之訓練方法,並使用病患對於改變之感知作為結果,以評估強制性訓練之長期功效。