Delivering Effective Messages in the Patient-Clinician Encounter

Cappella, Joseph N.; Street, Richard L.

doi:10.1001/jama.2024.0371

Cited by 13 publications

(2 citation statements)

References 9 publications

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“…The information must be anchored in the patient's lifeworld. This is achieved, on the one hand, through linguistic appropriateness, which is known to be an important prerequisite for delivering bad news [11,39,40], but also through concrete orientation to the reality of the patients' lives themselves and values [13]. Informational and emotional needs are closely linked and influence each other.…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that that the "quality" of communication influences patient-related outcomes such as subjective well-being [9], reduction of anxiety [10], and the decision to continue or stop medical treatment under the guidance of the specialist who had delivered the bad news to them [11]. In addition, bad communication can be medically significant and a source of distress for patients, relatives, and health care professionals (HCPs) [12,13]. Although communicating bad news is an integral part of an oncologists daily routine, there are only few comprehensive guidelines [14][15][16], and these have been predominantly developed by "expert opinion" and without patient involvement [17].…”

Section: Introductionmentioning

confidence: 99%

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Rethinking parameters of “success” in breaking bad news conversations from patient’s perspective: the successful delivery process model

Koch,

Seifart

2024

Support Care Cancer

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Purpose Studies that focus on improving the difficult process of breaking bad news in oncology should include the patient perspective and be guided by appropriate outcome measures. Endpoints such as “patient satisfaction” fall short to capture the complex nature of breaking bad news (BBN) conversations. However, this is true of many studies. The present study attempts to develop a framework model from a new, patient-centered perspective, which can be applied equally in clinical practice and in education. Methods Semi-structured in-depth interviews with twelve cancer patients were conducted. Transcripts were analyzed by “qualitative content analysis” following Mayring. Outcomes were further extrapolated in interpretational steps, and a model of “success” from patients view in BBN was developed. Results Two central needs of the patients could be identified: understanding and feelings. Their fulfillment depends on two groups of variables: first, structural characteristics, such as the inevitable shock, individuality, and processability; second, strongly influenceable variables, such as relationship, transfer of knowledge, and atmosphere. From these results, a framework model for successful breaking of bad news from the patient’s perspective was developed: The successful delivery process model (SDP model). Conclusion As a basic model for the framework for breaking bad news from the patient’s perspective, the SDP model can be applied to many different situations in oncology and help to frame the difficult conversations by tailoring the BBN conversations on determinants that favorably influence the process in a patient centered manner. In this sense, the model can be useful in clinical practice as well as in education.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rethinking parameters of “success” in breaking bad news conversations from patient’s perspective: the successful delivery process model

Koch,

Seifart

2024

Support Care Cancer

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Communicating Medicine—A New JAMA Series

Cappola,

Bibbins-Domingo

2024

JAMA

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The manner in which medical information is communicated by clinicians has a major effect on patients. However, patients also receive medical information from sources other than clinicians or health care environments. Although information from the mainstream media, the internet, or social media may be more accessible for patients, these sources can present challenges for communication during the clinical encounter, particularly if real or perceived risks of a medical intervention are magnified and benefits are minimized. Clinicians have an important role as trusted sources of medical information. Helping clinicians deliver accurate information more effectively can lead to betterinformed patients.JAMA's mission is to promote the science and art of medicine and the betterment of public health. JAMA pursues this mission by publishing original research with Editorials and Viewpoints to provide the context for scientific findings and articles that educate readers on important clinical topics. JAMA publishes for a broad audience that includes scientists, clinicians, patients, health care leaders, policymakers, the media, and the lay public. An important priority for JAMA is helping clinicians provide evidence-based care to patients. Because communication in the clinical encounter is important for effective patient care, JAMA aims to help clinicians accurately and effectively communicate medical information to patients and help patients obtain unbiased information relevant to health.JAMA is launching an Insights series titled "Communicating Medicine" as a forum to introduce strategies for the clinician to improve communication of medicine and healthrelated topics to patients. The first in this series, "Strategies to Improve Medical Communication" by Cappola and Cohen, was previously published and described a framework from communications literature for examining information exchange in the clinical encounter. 1 In the current issue of JAMA, the article "Delivering Effective Messages in the Patient-Clinician Encounter" by Cappella and Street discusses strategies for clinicians to share credible and clear health information with their patients. 2 JAMA invites new submissions for this series. Articles in this series will be approximately 1000 words in length with an accompanying table or figure. Submissions should be based on rigorous research from the medical, communications, and social science literature. JAMA looks forward to launch of this new series and welcomes readers' comments and feedback. Inquiries can be made to section editor

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Improving Medical Communication—Reply

Cappola,

Cohen

2024

JAMA

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COMMENT & RESPONSEIn Reply Drs Anderson and Ledford bring to our attention meaningful classifications for medical communication. It is indeed helpful to categorize medical communication into interpersonal, organizational, and mass media since each type has different needs and stipulations.Anderson and Ledford rightly point out that medical communication needs to be patient-centered and bidirectional. We acknowledge that the title of the figure "Information Flow in Medical Communication" in our article 1 implies a model with a unidirectional flow of information from clinician to patient. This was, however, not our intent. We completely agree that communication strategies need to be personalized and targeted to the individual patient, as we outline in the section of our article titled "Social Context: Belief System of the Patient." The objective of our article was to present a broad framework based on strategies that have shown success in message persuasion and behavior change in other fields such as public health, social science, and marketing, rather than to present a model for medical communication. It is imperative to incorporate patient-centered communication within these broad strategies. The next article in the series, "Delivering Effective Messages in the Patient-Clinician Encounter" by Drs Cappella and Street provides evidence-based approaches that emphasize the patient-centered and interactional nature of patientclinician communication. 2 We also agree with Anderson and Ledford that communication scientists should advise clinicians and collaborate with them to develop effective communication strategies. Additionally, we welcome diverse points of view and approaches in this developing field and invite communication scientists with the authors' expertise to submit articles to the Communicating Medicine series. 3

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Delivering Effective Messages in the Patient-Clinician Encounter

Abstract: This JAMA Insights discusses the importance of effective patient-clinician communication and provides strategies for clinicians that can enhance accurate information gathering and exchange, encourage patient engagement, enhance comprehension, and ensure retention of the information.

Cited by 13 publications

References 9 publications

Rethinking parameters of “success” in breaking bad news conversations from patient’s perspective: the successful delivery process model

Rethinking parameters of “success” in breaking bad news conversations from patient’s perspective: the successful delivery process model

Communicating Medicine—A New JAMA Series

Improving Medical Communication—Reply

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