緩和ケアと医学

抽象的な

Communication Skills Training Significantly Improves Lung Cancer Patient`s Understanding

Wiebke Nehls, Sabine Gabrijel, Alexander Kiss, Sandra Delis, Nina-Barbara Blac, Jens Kollmeier, Andrea Koch and Torsten Bauer

Introduction: We investigated whether a communication skill training (CST) for physicians leads to improved satisfaction of patients with the disclosure procedure about lung cancer and whether the patient´s recall can be improved.
Methods: In an observation study 101 patients, who were disclosed about their lung cancer diagnosis, were questioned about the recall and satisfaction regarding diagnosis, therapy and therapy goal. The contents of the physicians’ structured questionnaire were then matched with the questions posed to patients in interviews regarding recall. A total of 37 physicians from the lung cancer center attended to a structured CST with simulated patients on basis of the SPIKES model. After this intervention, 100 diagnosed patients were interviewed accordingly.
Results: Patients recall of diagnosis and therapy was very high in the observational study (correct recall of diagnosis 86%, correct recall of therapy 81%). The recall results of the physicians trained in communication were comparably high (80% and 82%). The recall of the therapeutic goal respectively, were initially low (42%) and could be raised significantly using the CST (61%; p=0.009). The level of satisfaction with the conversation about diagnosis and therapy was high in both studies. Patients` satisfaction with communication about the treatment goal improved significantly when disclosed by trained physicians (81% versus 53%; p<0.001).
Conclusion: Lung cancer patients do understand the therapeutic goal and their prognosis better, if the disclosing physician took part in a CST. Moreover, patients are more satisfied with the conversation about their prognosis, when trained physicians explain the disease.