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THE EFFECTIVENESS OF "DELIVERING UNFAVORABLE NEWS TO PATIENTS DIAGNOSED WITH CANCER" TRAINING PROGRAM FOR ONCOLOGISTS IN UZBEKISTAN
Title
THE EFFECTIVENESS OF "DELIVERING UNFAVORABLE NEWS TO PATIENTS DIAGNOSED WITH CANCER" TRAINING PROGRAM FOR ONCOLOGISTS IN UZBEKISTAN.
Creator
Hundley, Gulnora, Robinson, Edward H., University of Central Florida
Abstract / Description
Effective physician-patient communication is primary to successful medical consultation and encourages a collaborative interactional process between patient and doctor. Collaborative communication, rather than one-way authoritarian, physician-led medical interview, is significant in navigating difficult circumstances such as delivering "bad news" to patients diagnosed with cancer. Additionally, the potential psychological effects of breaking bad news in an abrupt and insensitive manner can be...
Show moreEffective physician-patient communication is primary to successful medical consultation and encourages a collaborative interactional process between patient and doctor. Collaborative communication, rather than one-way authoritarian, physician-led medical interview, is significant in navigating difficult circumstances such as delivering "bad news" to patients diagnosed with cancer. Additionally, the potential psychological effects of breaking bad news in an abrupt and insensitive manner can be devastating and long-lasting for both the patient and his or her family. The topic of delivering unfavorable news to patients is an issue that many medical professionals find to be challenging and is now getting the attention of medical professionals in many countries, including the former Soviet Union (FSU) republics. The limited literature on communication skills in oncology in the FSU republics supports that the physician-patient communication style is perceived as significantly physician-oriented rather than patient-oriented. More specifically, the Soviet medical education system, as well as post-graduate medical education, has placed little to no emphasis on physician-patient communication training. Physician-oriented communication leads to patients being less forthcoming and open regarding their own feelings about being diagnosed with cancer, which may exacerbate the overall communication problem. The purpose of this study was to investigate the effectiveness of the training program "Delivering Unfavorable News to Patients Diagnosed with Cancer" (Baile et al., 2000) conducted in Uzbekistan, one of the FSU republics. A total of 50 oncologists from the National Oncology Center of Uzbekistan (N = 50, n = 25 , n = 25 ) completed Self-Efficacy, Interpersonal skills (FIRO-B), Empathy (JSPE), and Physician Belief (PBS), and demographic instruments before, immediately after, and then two weeks after the training intervention. Results of MANOVA and bivariate statistical analyses revealed significant differences in self-efficacy, empathy, and PBS scores within the experimental group, but not within the control group, from pre-test to post-test. The follow-up data analysis suggested that participants maintained the level of change that occurred immediately after the training intervention.
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Date Issued
2008
Identifier
CFE0002043, ucf:47596
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0002043
MENTAL HEALTH INTERVENTIONS FOR ADOLESCENT CANCER PATIENTS
Title
MENTAL HEALTH INTERVENTIONS FOR ADOLESCENT CANCER PATIENTS.
Creator
Faherty, Kelsey A, Loerzel, Victoria, University of Central Florida
Abstract / Description
Background: According to the National Cancer Institute (2017) approximately 15,270 individuals' ages 0 to 19 years would be diagnosed with cancer in 2017. Although pediatric cancer survival rates continue to rise, there are high rates of anxiety, fear, and depression amongst this population. The purpose of this literature review was to explore mental health interventions for adolescent cancer patients. Methodology: A total of 165 articles were found in a literature search. Databases used...
Show moreBackground: According to the National Cancer Institute (2017) approximately 15,270 individuals' ages 0 to 19 years would be diagnosed with cancer in 2017. Although pediatric cancer survival rates continue to rise, there are high rates of anxiety, fear, and depression amongst this population. The purpose of this literature review was to explore mental health interventions for adolescent cancer patients. Methodology: A total of 165 articles were found in a literature search. Databases used include: CINAHL Plus with Full Text, Cochrane Center Register of Controlled Trials, Cochrane Clinical Answers, MEDLINE, and PsycINFO. As results were further narrowed based on relevance and set limiters a total of 7 articles were used for the purpose of this review. Results: Multiple interventions were used in the purpose of this review including therapeutic play, animal-assisted activities, complementary and alternative medicine interventions, and coping and stress reduction interventions. Interventions used significantly decreased anxiety, fear, and depression amongst adolescent cancer patients. Conclusion: One intervention was not more successful than another. Interventions that included participants in their plan of care, promoted normalcy, and were developmentally appropriate were successful at decreasing anxiety, depression, and fear in adolescent cancer patients.
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Date Issued
2018
Identifier
CFH2000365, ucf:45791
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH2000365
Identification of Areas of Patient Need Using the Cancer Support Source Program
Title
Identification of Areas of Patient Need Using the Cancer Support Source Program.
Creator
Ross, Emily, Cassisi, Jeffrey, Jensen, Bernard, Robinson, Diane, University of Central Florida
Abstract / Description
Understanding, screening, and providing resources for quality of life factors and psychosocial distress have become an important area of focus in cancer care. Negative consequences of poor quality of life and psychosocial distress have been widely studied in oncological research. The National Comprehensive Cancer Network, or NCCN, defines (")psychosocial distress(") as extending on a continuum, (")ranging from common normal feelings of vulnerability, sadness, and fears to problems that can...
Show moreUnderstanding, screening, and providing resources for quality of life factors and psychosocial distress have become an important area of focus in cancer care. Negative consequences of poor quality of life and psychosocial distress have been widely studied in oncological research. The National Comprehensive Cancer Network, or NCCN, defines (")psychosocial distress(") as extending on a continuum, (")ranging from common normal feelings of vulnerability, sadness, and fears to problems that can become disabling, such as depression, anxiety, panic, social isolation, and existential and spiritual crisis(") ((")National Comprehensive Cancer Network,(") n.d.). Findings have indicated the significant impact of poor quality of life and psychosocial distress in the cancer patient population. Elevated levels of psychosocial distress increases the risk of developing depression, anxiety, immune suppression, and may lead to high levels of stress. Studies have also revealed associations between increased psychosocial distress levels, relapse, treatment and healing outcomes, and survival rates (Anderson, Kiecolt-Glaser, (&) Glaser, 1994; Spiegel (&) Nemeroff, 1997). Evidence also shows that heightened psychosocial distress negatively influences a patient's capability to adhere to their medical plan and treatment (Allison et al., 1995; Pirl et al., 2007; Zabora, Brintzenhofeszoc, Curbow, Hooker, (&) Piantadosi, 2001). Attending to these negative outcomes of psychosocial distress and providing supportive care is a crucial action of oncology practice today. The American College of Surgeons Commission on Cancer responded to the imperative of addressing psychosocial needs in cancer care by mandating national cancer centers for accreditation purposes to screen for psychosocial distress and provide appropriate referral and resources (Standard 3.2). UF Health Cancer Center (-) Orlando Health began psychosocial distress screening on January 1st, 2015 with the utilization of the Web-based, HIPPA compliant, and action based Cancer Support Source Program. Patient data responses collected with the Cancer Support Source Program over the first calendar year of the implementation of the American College of Surgeons Commission on Cancer standards were analyzed for this research study. A sample of 317 patient data responses was included to conduct an exploratory factor analysis (EFA) on the Cancer Support Source Program test items. Specifically, a Principal Component Analysis (PCA) with an oblique rotational procedure (Promax) was conducted on the resulting data set for interpretation. Factorial interpretation was made to ascertain latent dimensions in the Cancer Support Source Program. A five factor structure model was found with adequate discriminant and face validity. Factors were grouped by conceptual basis and item-loading composition: Distress, Treatment Management and Decisions, Lifestyle, Relationship, and Substance Use. These factors were collectively termed the Concern Subscales. The Distress, Treatment Management and Decisions, and Lifestyle Factors were found to present the most psychometrically sound and internally consistent model. Further analysis was conducted to examine the resulting factorial structure model on four cancer location groups: breast, head and neck, lung, and gynecological cancer. Results displayed that no significant differences were found between cancer location groups and the five extracted factors. However, an ad hoc test (Tukey's HSD) revealed two significant differences between the Lifestyle Factor and cancer location groups at the p (<) 0.05 level. The Breast Cancer group's Lifestyle scores were higher than the Gynecologic Cancer group, and the Breast Cancer group scores were lower than the Lung Cancer group. Additionally, the action scores were summed to examine correlation between the five extracted Concern Subscales. A high correlation was found, indicating that the action items in the Cancer Support Source questionnaire correspond with the extracted Concern Subscales and do not need to undergo dimension reduction. Furthermore, a high correlation was also found with the extracted Distress Concern Subscale and the existing depression subscale in the Cancer Support Source Program.Results indicated that the Cancer Support Source Program could indeed benefit from dimension reduction to ascertain more parsimonious areas of need presented by the cancer patient population. The 25 single-items in the Cancer Support Source questionnaire may inhibit the ability to indicate other concerns that may be expressed by the patient. By identifying the latent dimensions in this exploratory endeavor, we were able to demonstrate how the Cancer Support Source questionnaire could be refined to include easily scored Concern subscales to better identify areas of need for each individual patient that is screened for psychosocial distress. These findings provide an opportunity to impact patient care, opportunities for referral, and resources for cancer care in a hospital setting using this psychosocial distress screening instrument.
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Date Issued
2017
Identifier
CFE0006650, ucf:51254
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0006650