title: Factors influencing physicians' detection of cancer patients' and relatives' distress: can a communication skills training program improve physicians' detection?
abstract: 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.
authors.affiliation: Unité de Recherche en Psychosomatique et Psycho-oncologie, Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Merckaert
authors.forename: Yves
authors.initials: Y
authors.lastname: Libert
authors.forename: Nicole
authors.initials: N
authors.lastname: Delvaux
authors.forename: Serge
authors.initials: S
authors.lastname: Marchal
authors.forename: Jacques
authors.initials: J
authors.lastname: Boniver
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Etienne
authors.forename: Jean
authors.initials: J
authors.lastname: Klastersky
authors.forename: Christine
authors.initials: C
authors.lastname: Reynaert
authors.forename: Pierre
authors.initials: P
authors.lastname: Scalliet
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Slachmuylder
authors.forename: Darius
authors.initials: D
authors.lastname: Razavi
mesh_terms: 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