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Addressing the quality of communication with older cancer patients with cognitive deficits: Development of a communication skills training module

Published online by Cambridge University Press:  16 April 2020

Beatriz Korc-Grodzicki ,
Yesne Alici ,
Christian Nelson ,
Koshy Alexander ,
Ruth Manna ,
Natalie Gangai ,
Megan J. Shen Open the ORCID record for Megan J. Shen [Opens in a new window] ,
Patricia A. Parker  and
Smita C. Banerjee Open the ORCID record for Smita C. Banerjee [Opens in a new window]
Beatriz Korc-Grodzicki*
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
Yesne Alici
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
Christian Nelson
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
Koshy Alexander
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
Ruth Manna
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
Natalie Gangai
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
Megan J. Shen
Affiliation:
Weill Cornell Medical College, New York, NY
Patricia A. Parker
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
Smita C. Banerjee
Affiliation:
Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY
*
Author for correspondence: Beatriz Korc-Grodzicki, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY10065, USA. E-mail: korcgrob@mskcc.org
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Abstract

Objective

Effective communication is an essential part of patient-centered care. The complexity of cancer care in older adults makes communication challenging, particularly when older patients have cognitive deficits and lose their autonomy. This paper describes the development, implementation, and evaluation of a communication skills training module for health care providers (HCPs) who work with older adults with cancer, with or at risk of developing cognitive deficits.

Method

Using a pre-post single arm study design, 99 HCPs from a comprehensive cancer center in North-East USA, who worked primarily with geriatric patients, participated in the study. Participants included Advance Practice Providers (including Nurse Practitioners and Physician Assistants; n = 24, 24.2%); nurses (n = 23, 23.2%), social workers (n = 14, 14.1%), physicians (n = 13, 13.1%), and “other” HCPs (including occupational therapists, physical therapists, and psychologists; n = 20, 20.2%). The HCPs participated in a one-day geriatric communication skills training program in groups of 12–15 over a 2-year period. Participants complete pre-post surveys on module evaluation and perception of self-efficacy as well as pre-post video-recorded Standardized Patient Assessment (SPA) to evaluate communication skill uptake.

Results

Most participants evaluated the module positively; over 90% indicated that they agreed or strongly agreed with five of the six module evaluation items. HCPs’ self-efficacy in communicating with cancer patients with cognitive deficits significantly increased from pre- to post-module training. There was a significant increase in the following communication skill use from pre- to post-training: checking patient preferences, declaring agenda, and inviting agenda.

Significance of results

Results demonstrated a successful implementation of the program as evidenced through favorable program evaluation, significant gains in self-efficacy, as well as significant improvement in several communication skills.

Keywords

Cognitive syndromeCommunication skills trainingGeriatricsOncologyStandardized patient assessments
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Special Issue 4: Palliative and Supportive Care During The COVID-19 Pandemic , August 2020 , pp. 419 - 424
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Copyright
Copyright © Cambridge University Press 2020

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References

Adelman, RD, Greene, MG and Ory, MG (2000) Communication between older patients and their physicians. Clinics in Geriatric Medicine 16(1), 1–24. vii. doi:10.1016/s0749-0690(05)70004-5CrossRefGoogle ScholarPubMed
Amalraj, S, Starkweather, C, Nguyen, C, et al. (2009) Health literacy, communication, and treatment decision-making in older cancer patients. Oncology 23, 369–375.Google ScholarPubMed
Andreotti, C, Root, JC, Alici, Y, and Ahles, T. (2015a) Cognitive disorders and delirium. In Holland, J, Wiesel, TW, Nelson, CJ, Roth, AJ, Alici, Y (eds), Geriatric Psycho-Oncology: A Quick Reference on the Psychosocial Dimensions of Cancer Symptom Management. New York, NY: Oxford University Press, pp. 51–58.Google Scholar
Andreotti, C, Root, JC, Ahles, TA, et al. (2015b) Cancer, coping, and cognition: A model for the role of stress reactivity in cancer-related cognitive decline. Psychooncology 24, 617–623. doi:10.1002/pon.3683CrossRefGoogle Scholar
Banerjee, S, Manna, R, Coyle, N, et al. (2017) The implementation and evaluation of a communication skills training program for oncology nurses. Translational Behavioral Medicine 7, 615–623. doi:10.1007/s13142-017-0473-5CrossRefGoogle ScholarPubMed
Bialer, PA, Kissane, D, Brown, R, et al. (2011) Responding to patient anger: Development and evaluation of an oncology communication skills training module. Palliative & Supportive Care 9, 359–365. doi:10.1017/S147895151100037XCrossRefGoogle ScholarPubMed
Bylund, CL, Brown, RF, Gueguen, JA, et al. (2010) The implementation and assessment of a comprehensive communication skills training curriculum for oncologists. Psychooncology 19, 583–593. doi:10.1002/pon.1585CrossRefGoogle ScholarPubMed
Bylund, CL, Brown, RF, Bialer, PA, et al. (2011) Developing and implementing an advanced communication training program in oncology at a comprehensive cancer center. Journal of Cancer Education 26, 604–611. doi:10.1007/s13187-011-0226-yCrossRefGoogle Scholar
Donovan-Kicken, E and Caughlin, JP (2011) Breast cancer patients’ topic avoidance and psychological distress: The mediating role of coping. Journal of Health Psychology 16, 596–606. doi:10.1177/1359105310383605CrossRefGoogle ScholarPubMed
Hagerty, RG, Butow, PN, Ellis, PM, et al. (2005) Communicating with realism and hope: Incurable cancer patients’ views on the disclosure of prognosis. Journal of Clinical Oncology 23, 1278–1288. doi:10.1200/JCO.2005.11.138CrossRefGoogle ScholarPubMed
Hurria, A, Dale, W, Mooney, M, et al. (2014) Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations. Journal of Clinical Oncology 32, 2587–2594. doi:10.1200/JCO.2013.55.0418CrossRefGoogle ScholarPubMed
Inouye, SK, Westendorp, RG and Saczynski, JS (2014) Delirium in elderly people. Lancet 383, 911–922. doi:10.1016/S0140-6736(13)60688-1CrossRefGoogle ScholarPubMed
Institute of Medicine (US) Committee on Quality of Health Care in America (2001) Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press. Available at: https://www.ncbi.nlm.nih.gov/books/NBK222274/ doi: 10.17226/10027Google Scholar
Jin, J, Sklar, GE, Min Sen Oh, V, et al. (2008) Factors affecting therapeutic compliance: A review from the patient's perspective. Therapeutics and Clinical Risk Management 4, 269–286. doi:10.2147/tcrm.s1458Google ScholarPubMed
Joint Commission (2011) Patient-Centered Communication Standards for Hospitals. R3 Report, 1. Available at: https://www.jointcommission.org/standards/r3-report/r3-report-issue-1-patient-centered-communication/Google Scholar
Kerr, J, Engel, J, Schlesinger-Raab, A, et al. (2003) Communication, quality of life and age: Results of a 5-year prospective study in breast cancer patients. Annals of Oncology 14, 421–427. doi:10.1093/annonc/mdg098CrossRefGoogle ScholarPubMed
Kissane, DW, Bylund, CL, Banerjee, SC, et al. (2012) Special series (Whole patient): Communication skills training for oncology professionals. Journal of Clinical Oncology 30, 1242–1247. doi:10.1200/JCO.2011.39.6184CrossRefGoogle Scholar
Kolva, E, Rosenfeld, B and Saracino, R (2018) Assessing the decision-making capacity of terminally ill patients with cancer. American Journal of Geriatric Psychiatry 26, 523–531. doi:10.1016/j.jagp.2017.11.012CrossRefGoogle ScholarPubMed
Lange, M, Rigal, O, Clarisse, B, et al. (2014) Cognitive dysfunctions in elderly cancer patients: A new challenge for oncologists. Cancer Treatment Reviews 40, 810–817. doi:10.1016/j.ctrv.2014.03.003CrossRefGoogle ScholarPubMed
Lawlor, PG, Gagnon, B, Mancini, IL, et al. (2000) Occurrence, causes, and outcome of delirium in patients with advanced cancer: A prospective study. Archives of Internal Medicine 160, 786–794. doi:10.1001/archinte.160.6.786CrossRefGoogle ScholarPubMed
McKoy, JM, Burhenn, PS, Browner, IS, et al. (2014) Assessing cognitive function and capacity in older adults with cancer. Journal of the National Comprehensive Cancer Network 12, 138–144. doi:10.6004/jnccn.2014.0011CrossRefGoogle ScholarPubMed
National Comprehensive Cancer Network® (NCCN) (2019) NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Older Adult Oncology, Version 1.2019. Available at: https://www.nccn.org/professionals/physician_gls/Google Scholar
Palmore, E (2015) Ageism comes of age. The Journals of Gerontology: Series B 70, 873–875. https://doi.org/10.1093/geronb/gbv079CrossRefGoogle ScholarPubMed
Saracino, R, Nelson, CJ, and Roth, AJ. (2017) Communication with cognitively impaired older adults and their families. In Korc-Grodzicki, B and Tew, WP (eds), Handbook of Geriatric Oncology. New York: Springer, pp. 265–272.Google Scholar
Schroyen, S, Adam, S, Jerusalem, G, et al. (2014) Ageism and its clinical impact in oncogeriatry: State of knowledge and therapeutic leads. Clinical Interventions in Aging 10, 117–125. doi:10.2147/CIA.S70942CrossRefGoogle ScholarPubMed
Smith, BD, Smith, GL, Hurria, A, et al. (2009) Future of cancer incidence in the United States: Burdens upon an aging, changing nation. Journal of Clinical Oncology 27, 2758–2765. doi:10.1200/JCO.2008.20.8983CrossRefGoogle Scholar
Thomas, DC, Leipzig, RM, Smith, LG, et al. (2003) Improving geriatrics training in internal medicine residency programs: Best practices and sustainable solutions. Annals of Internal Medicine 139, 628–634. doi:10.7326/0003-4819-139-7-200310070-00037CrossRefGoogle ScholarPubMed
Weiss, BD and Fain, MJ (2009) Geriatric education for the physicians of tomorrow. Archives of Gerontology and Geriatrics 49(Suppl 2), S17–S20. doi:10.1016/S0167-4943(09)70007-XCrossRefGoogle ScholarPubMed
Wilkins, KM, Lund, BC, McAdams, JD, et al. (2009) Clinical utility of the Hopkins Competency Assessment Test on an inpatient geropsychiatry unit. American Journal of Alzheimers Disease and Other Dementias 24, 34–39. doi:10.1177/1533317508326374CrossRefGoogle Scholar