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Psychooncology for non-psychooncologists

Psychooncology for non-psychooncologists. A Kiss 21.05.08. What do cancer patients want from their oncologists?. Technical Competence (Disease) Psychosocial Competence (Illness). Communication with patients and relatives. Giving bad news Dealing with emotions Giving complex informations

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Psychooncology for non-psychooncologists

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  1. Psychooncology for non-psychooncologists A Kiss 21.05.08

  2. What do cancer patients want from their oncologists? • Technical Competence (Disease) • Psychosocial Competence (Illness) Präsentationstitel in der Fusszeile des Folienmasters definieren

  3. Communication with patients and relatives • Giving bad news • Dealing with emotions • Giving complex informations • Talking about risk and benefits • Shared Decision Making • Involving in RCT • Talking about CAM • Talking about psychosocial distress Präsentationstitel in der Fusszeile des Folienmasters definieren

  4. Präsentationstitel in der Fusszeile des Folienmasters definieren

  5. Ptacek JT et al.: Patients' perceptions of receiving bad news about cancer. J Clin Oncol 2001; 19: 4160-4 • Higher satisfaction (n=120) • Quiet room • No interruption (Pager, Telephone) • Physician sits near patient • Physicians shows empathy • Physician announces bad news Präsentationstitel in der Fusszeile des Folienmasters definieren

  6. How to break bad news 1 • Before the consultation: • Read the documents, pager, quiet room • During the consultation: • Sit down, relatives ?, time limit • Open question or focused question • Announcing ("I am sorry but…….") • Use simple words. Talk slowly. Be prepared to be interrupted Präsentationstitel in der Fusszeile des Folienmasters definieren

  7. How to break bad news 2 • Dealing with Emotions: NURSE • Naming • Understanding • Respect • Support • Elucidate Präsentationstitel in der Fusszeile des Folienmasters definieren

  8. How to break bad news 3 • No premature comfort • Wait, ask for questions • What's next ("Are there any Good News"?) • Checking understanding • Next consultation • After the Consultation: • Take a deep breath Präsentationstitel in der Fusszeile des Folienmasters definieren

  9. Communication skills training ? • How should we train? • How long should such a training be? • Is such a training effective? Präsentationstitel in der Fusszeile des Folienmasters definieren

  10. 160 Oncologists from 34 centers • 3-day communication skills training course • Randomly allocated to 4 groups: A: Written feedback + course B: Course C: Written feedback D: No Intervention • Outcome : 6-10 Videos with patients ( before / after) Präsentationstitel in der Fusszeile des Folienmasters definieren

  11. Fallowfield L et al. Efficacy of a cancer research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 2002; 359: 650-6 Präsentationstitel in der Fusszeile des Folienmasters definieren

  12. Evaluation of the Swiss Cancer League Communication Skills Program for Oncologists and Oncology NursesW.Langewitz, L. Szirt, H. Weber, M. Nübling Präsentationstitel in der Fusszeile des Folienmasters definieren

  13. Categories in physicians‘ communication: significant changes • Decrease of personal remarks (p<0.05) • Decrease of approvement (p<0.05) • Increase of checking (p<0.05) • Increase of checking for understanding (p<0.05) • Increase of bidding for repetition (p<0.05) • Increase of patient reactions after physician statements (p<0.01): indicating the professional use of pauses! • Increase of patient bringing up psycho-social topics after physician information: indicating more flexibility! Präsentationstitel in der Fusszeile des Folienmasters definieren

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