Effects of a communication training for oncologists on early addressing palliative and end-of-life care in advanced cancer care (PALLI-COM): a randomized, controlled trial

Harnischfeger, Nele; Rath, Hilke M; Alt-Epping, Bernd; Brand, H.; Haller, Karl; Letsch, Anne; Rieder, Nicola; Thuss‐Patience, Peter; Bokemeyer, Carsten; Bergelt, Corinna

doi:10.1016/j.esmoop.2022.100623

Cited by 7 publications

(3 citation statements)

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“…This multicenter cross‐sectional study investigated the relationship between oncologists' death anxiety and their PC/EoL communication skills with advanced cancer patients. Data originated from a multicenter randomized‐controlled trial (RCT) that evaluated the effectiveness of a newly developed communication skills training (PALLI‐COM) 28,29 . The RCT was funded by the German Cancer Aid (‘Deutsche Krebshilfe e.V.’) and was approved by the local ethics committees of all participating study sites (main approval by the medical ethics committee of the Medical Chamber of Hamburg on 19 November 2018; reference number: PV5910).…”

Section: Methodsmentioning

confidence: 99%

“…The RCT was funded by the German Cancer Aid (‘Deutsche Krebshilfe e.V.’) and was approved by the local ethics committees of all participating study sites (main approval by the medical ethics committee of the Medical Chamber of Hamburg on 19 November 2018; reference number: PV5910). The analyses conducted for the present study refer to the baseline measurement of this RCT 28,29 …”

Section: Methodsmentioning

confidence: 99%

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Association between oncologists' death anxiety and their end‐of‐life communication with advanced cancer patients

et al. 2023

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Objective:Early and open communication of palliative care (PC) and end-of-life (EoL)-related issues in advanced cancer care is not only recommended by guidelines, but also preferred by the majority of patients. However, oncologists tend to avoid timely addressing these issues. We investigated the role of oncologists' personal death anxiety in the rare occurrence of PC/EoL conversations. Methods:We conducted a multicenter cross-sectional study assessing oncologists' strengths and difficulties in self-reported and externally rated PC/EoL communication skills as well as their association with death anxiety. Death anxiety was assessed via the Thanatophobia-Scale. PC/EoL communication skills were assessed via validated questionnaires and study-specific items plus an external rating of videotaped medical consultation with simulated patients. A general linear model was conducted to analyze associations.Results: One hundred fifty-three oncologists participated (age: M(SD) = 32.9 years (6.9), 59.5% female). Both from the external and from their own perspective, oncologists had difficulties in addressing PC and the EoL. They avoided those aspects more than other topics in consultations with advanced cancer patients. Death anxiety was associated with more avoidant self-reported communication strategies, lower self-efficacy, less confidence in discussing the EoL and less confidence in discussing patients' goals and wishes, but was not associated with externally rated PC/EoL communication. Conclusions:Oncologists have experienced and externally observable difficulties in addressing PC and the EoL. Oncologists with higher death anxiety subjectively experience more difficulties. Group supervision and consultation offers might be means to empower oncologists, increase awareness of personal fears and enhance confidence and self-efficacy. This might facilitate earlier PC/EoL communication.Karin Oechsle and Corinna Bergelt should be considered joint senior author.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association between oncologists' death anxiety and their end‐of‐life communication with advanced cancer patients

et al. 2023

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“…Samtalet möjliggör för patienten att tillsammans med närstående kunna planera vardag och framtid samt förbereda ett värdigt slut och en fridfull död (156). För patientens och närståendes välbefinnande är det därför viktigt att tidigt i sjukdomsförloppet få sina behov identifierade och diskuterade i ett initierat samtal (147,157,158). Att tidigt föra samtal om sjukdomen, prognoser, prioriteringar och preferenser i livet och för framtida vård, ger ökade möjligheter för patienter och deras närstående att få vård och stöd anpassade för dem, så att de kan uppleva största möjliga livskvalité (159).…”

Section: Samtalens Betydelse För Patienterunclassified

Samtal vid allvarlig sjukdom - Kronobergsmodellen

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Aim: The overall aim of this thesis was to explore clinicians’ perceptions and self-efficacy regarding the use of the ‘Serious illness conversation’ structured workflow, and to explore their self-efficacy in caring for patients with palliative care needs. Methods: This thesis is comprised of four studies: two qualitative studies, one methodological study, and one quantitative study. In studies I and II, observations of clinic meetings and training sessions were undertaken with clinicians. Interviews were performed and a thematic analysis was conducted. In study III, the Self-Efficacy in Palliative Care scale (SEPC) was translated, adapted, and validated. In study IV, the SEPC-SE was completed by nurses and physicians. Factor analysis and Cronbach's alpha were calculated, and the Mann-Whitney U test was used to compare self-efficacy. Multiple linear regression was used to explore associated factors. Results: In study I, clinicians expressed that working with serious illness conversations was vital, but the conversations were also considered in terms of risks. The conversation training sessions created feelings of exposure but were perceived to be rewarding due to an increase in self-awareness. Obstacles in practice were identified as barriers to change. Study II showed that positive experiences and the group’s level of support, consensus, and behaviour was important for self-efficacy. Some clinicians were affected by perceived high demands, failures, anxiety, stress, when working with serious illness conversations. Study III showed that the SEPC-SE needed improvements in understandability and clarity. In study IV, the SEPC-SE reported high reliability. Physicians reported higher self-efficacy than nurses. Education at work and experience in advanced homecare had the strongest associations with self-efficacy. Conclusions: Implementing serious illness conversations can increase clinicians’ awareness about the importance of engaging in serious illness conversations and thus contribute to increased motivation through behavioural and attitudinal changes. However, building a support system for clinicians within the organisation seems essential for improving self-efficacy. The SEPC-SE was found to be valid and reliable. Clinicians’ estimation of their perceived self-efficacy indicates that healthcare organisations should prioritise work-related education and experience to improve self-efficacy in providing palliative care.

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Palliativmedizin/Onkologie: Kommunikationstraining erhöht ärztliche Kompetenz

2023

Psychother Psychosom Med Psychol

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Bei fortgeschrittenen Krebserkrankungen sollte das Thema Palliativmedizin rechtzeitig angesprochen werden. Da viele Onkologinnen/Onkologen sich auf kommunikativer Ebene noch unsicher fühlen, haben Harnischfeger et al. ein entsprechendes Trainingsprogramm entwickelt. In ihrer „Palliativmedizin und Versorgung am Lebensende in der fortgeschrittenen Krebsbehandlung“ (PALLI-COM)-Studie kommen sie dabei zu einem positiven Ergebnis.

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Effects of a communication training for oncologists on early addressing palliative and end-of-life care in advanced cancer care (PALLI-COM): a randomized, controlled trial

Cited by 7 publications

References 57 publications

Association between oncologists' death anxiety and their end‐of‐life communication with advanced cancer patients

Association between oncologists' death anxiety and their end‐of‐life communication with advanced cancer patients

Samtal vid allvarlig sjukdom - Kronobergsmodellen

Palliativmedizin/Onkologie: Kommunikationstraining erhöht ärztliche Kompetenz

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