“What concerns me is…” Expression of emotion by advanced cancer patients during outpatient visits

Anderson, Wendy G.; Alexander, Stewart C.; Rodriguez, Keri L.; Jeffreys, Amy S.; Olsen, Maren K.; Pollak, Kathryn I.; Tulsky, James A.; Arnold, Robert M.

doi:10.1007/s00520-007-0350-8

Cited by 68 publications

(56 citation statements)

References 57 publications

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“…In addition to giving unfavorable news, these discussions frequently arouse strong emotions in patients (28). Data suggest that providers often avoid emotional data and instead focus on the clinical data (16,(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Communication Skills Training for Dialysis Decision-Making and End-of-Life Care in Nephrology

Schell

Green

Tulsky

et al. 2013

Clinical Journal of the American Society of Nephrology

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106

108

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SummaryNephrology fellows often face difficult conversations about dialysis initiation or withdrawal but are frequently unprepared for these discussions. Despite evidence that communication skills are teachable, few fellowship programs include such training. A communication skills workshop for nephrology fellows (NephroTalk) focused on delivering bad news and helping patients define care goals, including end-of-life preferences. This 4-hour workshop, held in October and November 2011, included didactics and practice sessions with standardized patients. Participants were nephrology fellows at Duke University and the University of Pittsburgh (n=22). Preand post-workshop surveys evaluated efficacy of the curriculum and measured changes in perceived preparedness on the basis on workshop training. Overall, 14% of fellows were white and 50% were male. Less than one-third (6 of 22) reported prior palliative care training. Survey response rate varied between 86% and 100%. Only 36% (8 of 22) and 38% (8 of 21) of respondents had received structured training in discussions for dialysis initiation or withdrawal. Respondents (19 of 19) felt that communication skills were important to being a "great nephrologist." Mean level of preparedness as measured with a five-point Likert scale significantly increased for all skills (range, 0.5-1.14; P<0.01), including delivering bad news, expressing empathy, and discussing dialysis initiation and withdrawal. All respondents (21 of 21) reported they would recommend this training to other fellows. NephroTalk is successful for improving preparedness among nephrology fellows for having difficult conversations about dialysis decision-making and end-of-life care.

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Section: Discussionmentioning

confidence: 99%

Communication Skills Training for Dialysis Decision-Making and End-of-Life Care in Nephrology

Schell

Green

Tulsky

et al. 2013

Clinical Journal of the American Society of Nephrology

Self Cite

106

108

View full text Add to dashboard Cite

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“…Acknowledging emotion is a central component of showing empathy and facilitating discussion about patients' concerns, which may ameliorate distress even if the problems themselves cannot be solved. 82 Oncology patients do not often express negative emotions to their oncologists 83 but report an increased need to talk about their worries and fears. 66 Audio-recordings of consultations in America have found empathic opportunities are present in 37% of conversations, but oncologists give empathic responses less than one-third of the time; a low rate which likely discourages any further expression of emotion by patients.…”

Section: Style Of Delivery: Verbal and Nonverbal Aspectsmentioning

confidence: 99%

Deciding what information is necessary: do patients with advanced cancer want to know all the details?

Ward¹,

Russell²

2011

CMAR

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Abstract:Communicating effectively with patients who have advanced cancer is one of the greatest challenges facing physicians today. Whilst guiding the patient through complex diagnostic and staging techniques, treatment regimens and trials, the physician must translate often imprecise or conflicting data into meaningful personalized information that empowers the patient to make decisions about their life and body. This requires understanding, compassion, patience, and skill. This narrative literature review explores current communication practices, information preferences of oncology patients and their families, and communication strategies that may assist in these delicate interactions. Overwhelmingly, the literature suggests that whilst the majority of patients with advanced cancer do want to know their diagnosis and receive detailed prognostic information, this varies not only between individuals but also for a given individual over time. Barriers to the delivery and understanding of information exist on both sides of the physician-patient relationship, and family dynamics are also influential. Despite identifiable trends, the information preferences of a particular patient cannot be reliably predicted by demographic, cultural, or cancer-specific factors. Therefore, our primary recommendation is that the physician regularly asks the patient what information they would like to know, who else should be given the information and be involved in decision making, and how that information should be presented.

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“…[25] Furthermore, both physicians and cancer patients find it difficult to address emotional problems. [18,26] Moreover, the frequent assumption by healthcare providers that all cancer patients are "understandably depressed" is another most common factor that plays a role in the under-diagnosis of depression in cancer patients. [15] This may explain why the diagnosis of depression in cancer patients may easily be missed.…”

Section: Depression and Cancermentioning

confidence: 99%

Depression screening in cancer patients: A narrative review

Abid

Kehyayan

Johnson

2018

JNEP

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Depression is a significant and most common psychological symptom in cancer patients that causes a high risk of emotional and somatic consequences leading to poor quality of life. Despite the high prevalence of depression in cancer patients, the lack of screening and under-diagnosis of depression continues to be common. Numerous studies have shown that depression is a substantial complication in cancer patients that may lead to a variety of psychological and physical (somatic) symptoms. Presently, there are no depression screening practices at the Hamad Medical Corporation's (HMC) National Center for Cancer Care and Research (NCCCR), which is the principle public healthcare provider in the State of Qatar. The aim of this narrative review is to explore depression in cancer and discuss the need for screening for depression and to recommend suggestions and implications for future practice and research.

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“What concerns me is…” Expression of emotion by advanced cancer patients during outpatient visits

Cited by 68 publications

References 57 publications

Communication Skills Training for Dialysis Decision-Making and End-of-Life Care in Nephrology

Communication Skills Training for Dialysis Decision-Making and End-of-Life Care in Nephrology

Deciding what information is necessary: do patients with advanced cancer want to know all the details?

Depression screening in cancer patients: A narrative review

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