title: How can communication by oncologists enhance patients' trust? An experimental study.
abstract: BACKGROUND
  Cancer patients need to trust their oncologist to embark in the process of oncologic treatment. Yet, it is unclear how oncologist communication contributes to such trust. The aim of this study was to investigate the effect of three elements of oncologists' communication on cancer patients' trust: conferring competence, honesty, and caring.
  
  
  METHODS
  Eight videotaped consultations, 'vignettes', were created, reflecting an encounter between an oncologist and a patient with colorectal cancer. All vignettes were identical, except for small variations in the oncologist's verbal communication. Cancer patients (n = 345) were randomly assigned to viewing two vignettes, asked to identify with the patient and afterwards to rate their trust in the observed oncologist. The effects of competence, honesty, and caring on trust were established with multilevel analysis.
  
  
  RESULTS
  Oncologist's enhanced expression of competence (β = 0.17, 95% CI 0.08, 0.27; P < 0.001), honesty (β = 0.30, 95% CI 0.20, 0.40; P < 0.001), as well as caring (β = 0.36, 95% CI 0.26, 0.46; P < 0.001) resulted in significantly increased trust. Communication of honesty and caring also increased patients' expectation of operation success and reported willingness to recommend the oncologist.
  
  
  CONCLUSIONS
  As hypothesized, oncologists can influence their patients' trust by enhanced conveyance of their level of competence, honesty, and caring. Caring behavior has the strongest impact on trust. These findings can be translated directly into daily clinical practice as well as in communication skills training.
authors.affiliation: Departments of Medical Psychology. Electronic address: m.a.hillen@amc.uva.nl.
authors.forename: M A
authors.initials: MA
authors.lastname: Hillen
authors.affiliation: Departments of Medical Psychology.
authors.forename: H C J M
authors.initials: HCJM
authors.lastname: de Haes
authors.affiliation: Radiotherapy.
authors.forename: L J A
authors.initials: LJA
authors.lastname: Stalpers
authors.affiliation: Surgery, Academic Medical Center, University of Amsterdam, Amsterdam.
authors.forename: J H G
authors.initials: JHG
authors.lastname: Klinkenbijl
authors.affiliation: Department of Surgery, Deventer Hospital, Deventer, The Netherlands.
authors.forename: E H
authors.initials: EH
authors.lastname: Eddes
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED) - School of Psychology, University of Sydney, Sydney, Australia.
authors.forename: P N
authors.initials: PN
authors.lastname: Butow
authors.affiliation: Departments of Medical Psychology.
authors.forename: J
authors.initials: J
authors.lastname: van der Vloodt
authors.affiliation: Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: H W M
authors.initials: HWM
authors.lastname: van Laarhoven
authors.affiliation: Departments of Medical Psychology.
authors.forename: E M A
authors.initials: EMA
authors.lastname: Smets
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D035502:Trust / Q000523:psychology*; D014743:Videotape Recording
keywords: communication; physician–patient relations; trust; videotaped consultations