Improving patient emotional functioning and psychological morbidity: Evaluation of a consultation skills training program for oncologists.

Author(s): Girgis A, Cockburn J, Butow P, Bowman D, Schofield P, Stojanovski E, D'Este C, Tattersall MH, Doran C, Turner J

Affiliation(s): Centre for Health Research & Psycho-oncology (CHeRP), The Cancer Council NSW, University of Newcastle & Hunter Medical Research Institute, Room 230A, Level 2 David Maddison Building, Callaghan, NSW 2308, Australia.

Publication date & source: 2009-10-09, Patient Educ Couns., [Epub ahead of print]

OBJECTIVE: To evaluate whether a consultation skills training (CST) program with oncologists and trainees would improve skills in detecting and responding to patient distress, thereby improving their patients' emotional functioning and reducing psychological distress. METHODS: Randomized-controlled trial with 29 medical and radiation oncologists from Australia randomized to CST group (n=15) or usual-care group (n=14). The CST consisted of a 1.5-day face-to-face workshop incorporating presentation of principles, a DVD modelling ideal behaviour and role-play practice, and four 1.5h monthly video-conferences. At the CST conclusion, patients of participating doctors were recruited (n=192 in CST group, n=183 in usual-care group), completing telephone surveys at baseline, 1 week and 3 months to assess quality of life, anxiety, depression and unmet psychosocial needs. RESULTS: Despite high patient functioning at baseline, anxiety significantly improved at 1-week follow-up in the CST group, compared to the control group. There were no statistically significant differences in emotional functioning, depression or unmet supportive care need between the groups. CONCLUSION: Consistent trends for greater improvements were observed in intervention compared to control group patients, suggesting the CST program deserves wider evaluation. PRACTICE IMPLICATIONS: Video-conferencing after a short training course may be an effective strategy for delivering CST.