Training improves nurses’ communication with older cancer patients

After a communication skills training, oncology nurses communicate better and older cancer patients are more actively involved in the consultation. Researchers of NIVEL, Amsterdam and Sydney University recently published their findings in Critical Reviews in Oncology/Hematology.

“Before the training, the educational session in preparation for chemotherapy treatment was more or less one way traffic. Now, the consultation is more like an actual conversation (two way traffic) in which the patient plays an active role” according to Julia van Weert, researcher at the UvA. “Nurses are also more responsive to the patient’s emotions. At the start of chemotherapy treatments patients are commonly emotionally distressed which in turn affects their ability to take in and recall information. We have previously found that especially discussions about prognosis evoke emotions in patients. Older cancer patients remember less than a quarter of the nurses’ recommendations about chemotherapy treatment. It is therefore important to provide information at different points in time and to repeat the main recommendations.”

Communication tool
This study investigated older cancer patients’ involvement in the consultation and their uptake of the information presented. In preparation of the consultation, patients received a list of questions that they might wish to ask the nurse. As a result, patients asked more questions and had a more active role in the consultation. “Before the training the consultation focused mainly on information provision, with little space for the patient’s own agenda and emotions. We therefore advised nurses to reduce the amount of information presented and prioritize, in other words to focus on the information that patients really need and want at that phase of their disease.”

Less side effects
The information overload was indeed reduced. Before the training about 80 different topics were discussed in the consultation. Often, nurses talked about all possible side effects. After the training they focused on the more common ones. Julia van Weert: “Nurses still provide patients with a lot of information. However, information provision is not the sole aim of the consultation. It is as important that patients feel that they have been heard, that they are satisfied with the choice of treatment and that their own agenda (for example discussing plans for their future) was addressed. As a result of the training, nurses have provided the patients with more guidance and support. That is even more important for older patients.”

The study
A total of 210 patients and 77 nurses from ten different hospitals participated in this study. The nurses received individual video-feedback, a one-day, in-house communication skills training and a follow-up meeting. Nursing consultations preceding chemotherapy treatment were video-taped and patients completed a questionnaire immediately after the consultation. Communication skills were analyzed using a checklist. The communication skills training was developed in collaboration with The Netherlands Cancer Institute (NCI) in Amsterdam. The training is currently being used by several hospitals in the Netherlands and is supported by the Comprehensive Cancer Centres.

Cooperating partners
- University of Amsterdam (ASCoR)
- The Netherlands Cancer Institute (NCI) – Antoni van Leeuwenhoek Ziekenhuis
The University of Sydney, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED)