A randomized study assessing the efficacy of communication skill training on patients' psychologic distress and coping: nurses' communication with patients just after being diagnosed with cancer

Abstract

Background: Although studies have shown the usefulness of improving health professionals' communication skills by training, to the authors' knowledge none have demonstrated the efficacy of communication skill training (CST) for health professionals in terms of improving patient outcomes. This study aimed to assess the efficacy of CST for nurses in improving psychologic distress and coping among patients after being informed of a cancer diagnosis.

Methods: Nurses who mainly provide patients with psychologic and informational support after being informed of their cancer diagnosis by physicians at a cancer screening center were randomly assigned to either an experimental or a control group; patients were supported by either group of nurses. Patient selection criteria were: age >18 years with gastric, colorectal, or breast cancer that was not in advanced stage. Intervention consisted of 3 1-on-1 nurses' interviews (on the day of, 1 week after, and 1 month after diagnosis). Efficacy was assessed through patients' psychologic distress and coping by administering the Hospital Anxiety and Depression Scale (HADS) and Mental Adjustment to Cancer scale (MAC), at 3 time points (1 week, 1 month, and 3 months after diagnosis).

Results: Eighty-nine patients participated. Repeated measures analysis of variance demonstrated a significant group-by-time decrease in patients' psychologic distress on HADS (P = .03), and significant group-by-time increase in fighting spirit and decrease of fatalism (P = .01 and P = .04, respectively), in addition to significant between-group difference of anxious preoccupation on the MAC (P = .003).

Conclusions: Support by nurses who completed the CST program was found to reduce psychologic distress and improved coping long term among patients informed of their cancer diagnosis.