Factors influencing physicians' detection of cancer patients' and relatives' distress: can a communication skills training program improve physicians' detection?
OBJECTIVE
This study aimed to assess the impact on physicians' detection of patients' and relatives' distress of six 3-h consolidation workshops (CW) following a 2.5-day communication skills basic training (BT) program and to investigate factors associated with detection of distress.


METHODS
Physicians, after BT, were randomized to CW or to a waiting list. Physicians' detection of patients' and relatives' distress was measured through differences between physicians' ratings of patients' and relatives' distress (VAS) and patients' and relatives' self-reported distress (HADS). Communication skills were analysed according to the CRCWEM.


RESULTS
Mixed-effects modelling of physicians' detection of patients' distress showed a positive group by time effect in favour of physicians in the CW group. Detection of patients' distress was associated negatively with patients' distress, positively with physicians' concurrent use of psychological assessment and supportive skills, and negatively with general assessment skills. Mixed-effects modelling of physicians' detection of relatives' distress showed no significant group by time effect. Detection of relatives' distress was associated negatively with relatives' distress and with general assessment skills.


CONCLUSIONS
CW following a 2.5-day BT are needed to improve physicians' detection of patients' distress in three-person interviews. Results indicate the need to further improve physicians' detection of relatives' distress.
Merckaert
Isabelle
I
Unité de Recherche en Psychosomatique et Psycho-oncologie, Université Libre de Bruxelles, Bruxelles, Belgium.
Libert
Yves
Y
Delvaux
Nicole
N
Marchal
Serge
S
Boniver
Jacques
J
Etienne
Anne-Marie
AM
Klastersky
Jean
J
Reynaert
Christine
C
Scalliet
Pierre
P
Slachmuylder
Jean-Louis
JL
Razavi
Darius
D
D002983:Clinical Competence; D003142:Communication; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D003937:Diagnosis, Differential; D004493:Education / Q000706:statistics & numerical data; D004502:Education, Medical, Continuing / Q000706:statistics & numerical data; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D017603:Signal Detection, Psychological; D014850:Waiting Lists