Improving outcomes for people with cancer: Consultation skills training with oncologists

每年大约有30,000名澳大利亚人死于癌症，65,000名新的癌症患者被诊断出来。尽管为治愈癌症进行了大量研究，但癌症的发病率和死亡率并没有改变。现在新的治疗方法使癌症患者活得更长，所以我们现在需要把重点放在优化这些人的生活质量上。虽然认识到患者和家属的情感负担，但有一种感觉，这是疾病及其现有临床系统管理的不可避免的副产品。然而，情况并非如此。现在有充分的证据表明，医生与患者互动的方式可以影响诊断和预后的准确性，以及患者的满意度、对治疗指示的依从性和被诊断患有癌症后的生活质量。患者权益团体和临床医生都呼吁对医生进行进一步的培训，以有效地管理癌症治疗的心理社会方面，然而，尽管有这种支持，在澳大利亚进行这种培训的机会很少。我们为肿瘤学家开发了一个创新的咨询技能项目。为了评估该项目的有效性，它将作为一项随机对照试验实施，来自澳大利亚主要癌症诊所的肿瘤学家被随机分配到干预组或对照组。培训计划将通过视频会议进行，以克服许多阻碍忙碌的临床医生参加以前的培训计划的障碍。这是第一次在远程地点之间使用视像会议进行这类咨询技能培训的国际研究。将采用多种措施来评估培训的影响，包括患者的生活质量、焦虑、抑郁和感知需求，以及肿瘤学家的倦怠。

Each year approximately 30,000 Australians die from cancer and 65,000 new cancers are diagnosed. Despite much research for a cure for cancer, the incidence and mortality from cancer has not changed. New treatments now cause people with cancer to live longer with the disease, so we now need to focus on efforts to optimise the quality of life of these people. Although the emotional burden on patients and families is recognized, there is a sense that this is an inevitable by-product of the disease and its management in existing clinical systems. However, this does not need to be the case. There is now ample evidence that the way that doctors interact with their patients can effect the accuracy of diagnosis and prognosis, as well as patients' satisfaction, adherence with treatment instructions and quality of life after being diagnosed with cancer. Both patient advocate groups and clinicians have called for further training for doctors to effectively manage psychosocial aspects of cancer care, however, despite this support, there have been few opportunities for such training in Australia. We have developed an innovative consultation-skills program for oncologists. So that the effectiveness of the project can be evaluated, it will be implemented as a randomised controlled trial with oncologists from major Australian cancer clinics being randomly allocated to an intervention or control group. The training program will be delivered by videoconferencing, to overcome many of the barriers that have impeded busy clinicians from participating in previous training programs. This is the first international study to use videoconferencing between remote locations for this type of consultation skills training. A variety of measures will be used to evaluate the impact of the training, including patients' quality of life, anxiety, depression and perceived needs, and oncologists' burn-out.