Enhancing Patient-Oncologist Communication

加强患者与肿瘤科医生的沟通

• 批准号: 6744164
• 负责人: James A. Tulsky
• 金额: $ 64.27万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-05-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6744164
• 关键词: audiotape; behavioral /social science research tag; clinical research; clinical trials; communication behavior; computer human interaction; data management; education evaluation /planning; educational resource design /development; empathy; health services research tag; human subject; interactive multimedia; interpersonal relations; longitudinal human study; neoplasm /cancer education; neoplasm /cancer palliative treatment; outcomes research; patient care personnel relations; patient oriented research; physicians; prognosis; psychological aspect of cancer; psychological tests; quality of life; questionnaires

DESCRIPTION (provided by applicant): Communication about cancer treatment challenges patients and physicians as they face the transition from fighting a potentially curable disease to realizing that conventional therapies are no longer effective. Patients often confront intense fear and loss, leading to greater emotional needs than at any other time during treatment. Because oncologists also struggle with this transition, they frequently, yet inadvertently, discourage patients from disclosing emotional concerns and thus miss opportunities to communicate effectively, resulting in greater patient anxiety. Unfortunately, no easily disseminable educational interventions exist to help oncologists overcome these challenges. We propose a randomized, controlled trial testing the efficacy of an interactive CD-ROM based intervention using feedback from the oncologists' own recorded encounters to improve their communication. At baseline of this five-year, two site (Duke and the University of Pittsburgh) study, we will audio record 400 outpatient encounters between oncologists (n=50) and patients with advanced cancer (n=200) as they discuss the transition to palliative care. These digitized recordings will be coded for the oncologists eliciting patients' concerns and responding to emotional content. After baseline assessment, we will randomly assign the oncologists to intervention and control arms. The intervention oncologists each will receive a personalized user-friendly CD-ROM that contains their coded conversations, packaged with related educational material. A technical advisor will encourage and facilitate their use of materials. The control group will not receive the CD-ROM or any other support. Three months later, we will conduct the post-intervention assessment by recording another 400 clinic visits between these same oncologists (intervention and control) and a new sample of patients to measure the intervention impact. Primary outcomes will be the communication behaviors emphasized in the intervention, such as responding to empathic opportunities and eliciting patient concerns. This project will expand the field of oncologist-patient communication by identifying key communication skills that may assist patients through difficult transitions and by creating an easily disseminable intervention to help oncologists implement these skills.

描述（由申请人提供）：有关癌症治疗的沟通挑战患者和医生，因为他们面临着与潜在的可治愈疾病的过渡到意识到常规疗法不再有效的过渡。患者经常面对强烈的恐惧和失去，导致情绪需求比在治疗过程中的任何其他时间更大。由于肿瘤学家也为这种过渡而苦苦挣扎，因此他们经常但无意间会阻止患者披露情感问题，从而错过机会进行有效沟通的机会，从而导致更大的患者焦虑。不幸的是，没有很容易分发的教育干预措施可以帮助肿瘤学家克服这些挑战。我们提出了一项随机，对照试验，以使用肿瘤学家自己记录的相遇以改善其交流的反馈来测试基于交互式CD-ROM的干预措施的功效。在这个五年的两个地点（杜克大学和匹兹堡大学）的研究中，我们将在讨论过渡到姑息治疗的过渡时，在肿瘤学家（n = 50）和晚期癌症患者（n = 200）之间进行音频记录400个门诊病人的相遇（n = 50）。这些数字化的录音将用于肿瘤学家引起患者的关注并响应情感内容的编码。 在基线评估之后，我们将随机将肿瘤学家分配给干预和控制臂。干预肿瘤学家每个人都会收到个性化的用户友好的CD-ROM，其中包含其编码对话，并用相关的教育材料包装。技术顾问将鼓励和促进他们使用材料。对照组将无法获得CD-ROM或任何其他支持。三个月后，我们将通过记录这些相同的肿瘤学家（干预和对照）和新的患者样本之间的另外400次诊所就诊来进行干预后评估，以衡量干预影响。主要结果将是干预中强调的沟通行为，例如回应移情机会并引起患者的关注。该项目将通过确定可以通过艰难的过渡来帮助患者的关键沟通技巧并创建一种易于分散的干预措施来帮助肿瘤学家实施这些技能，从而扩大肿瘤学家沟通的领域。