Doctor-patient communication and outcome in cancer patients: An intervention

Abstract

Previous research suggests that the way in which doctors communicate with their patients has significant effects upon outcomes: “soft” outcomes such as satisfaction and compliance with treatment regimes; and “hard” outcomes such as need for analgesics and length of stay in hospital after surgical operations. The present investigation is concerned with cancer patients and tests whether providing oncologists with additional training in communication may promote patients' coping, quality of life and even survival. In the first part of the investigation, seventy-three patients at the University Hospital of Patras in Greece were followed for a year from the time of diagnosis. Patients were seen by the oncologist an hour or two before treatment began -chemotherapy or radiotherapy and were asked immediately after the consultation to rate the doctor's communication skills and behaviour. While there was little evidence that communication influenced either coping or quality of life six to eight weeks later, there was good evidence that patients' reported anxiety and depression as they came out of the consultation did have longer term effects. In the second part of the investigation, a new set of patients were assigned to have their pre-treatment consultation under one of two conditions: in the “experimental” condition doctors were trained to give information in a way that would be understood properly and would help to reduce anxiety and depression; in the “control” condition they received no special training and continued as before. The results showed that outcomes were markedly better in the experimental condition than the control condition, and that a reduction in anxiety and depression was the key factor.