لخّصلي

2010, the US Department of Health and Human Services (HHS) launched Healthy People 2020, an initiative that provides science-based national objectives for improving the health of all Americans. Healthy People 2020 is the third such 10-year agenda to be launched by the HHS. The goals and objectives of Healthy People 2020 take into consideration the importance of effective communication between health-care providers and patients in improving patient outcomes (HHS, 2013).

One goal of this health agenda is to increase the proportion of persons who report that their health-care providers have satisfactory communication skills, listen carefully to them, explain medical information in a way they (the patients) are able to understand, as well as show respect for what their patients have to say (HHS, 2013). Effective communication between health-care professionals and patients generates information that is beneficial to patient outcomes and supports patient-centered care. Furthermore, effective communication translates to increased patient knowledge and shared understanding, increased adherence to treatment recommendations, and the adoption of healthier habits and self-care strategies (Epstein & Street, 2007). Health-care providers continue to report difficulty communicating with patients, particularly when they are faced with addressing health-care challenges such as cancer.

Beginning at the time of diagnosis of cancer and continuing throughout treatment and survivorship, effective communication is vitally important to patient outcomes. It may determine how well a patient copes with the disease process and treatment (Maguire & Pitceathly, 2002). Unfortunately, ineffective communication may increase levels of anxiety in patients and create uncertainty (Lamont & Christakis, 2001).

Health-care providers address psychosocial concerns through effective communication strategies. These may include validating and exploring emotional concerns and providing health information to decrease unfavorable emotions such as anxiety (Iwamitsu, Shimoda, Abe, Okawa, & Buck, 2005). When a health-care provider demonstrates good communication skills, cancer patients are more apt to adhere to treatment recommendations and have improved psychosocial functioning (Arora, 2003). In addition, effective communication may help alleviate anxiety and other psychosocial concerns of oncology patients (Kennedy Sheldon, 2005).

The psychosocial concerns of a cancer diagnosis may overpower patient inquiries about the disease process, especially if the patient has fatalistic views about cancer and cancer treatment (McWilliam, Brown, & Stewart, 2000). These concerns may also affect a patient’s well-being and quality of life (Arora et al., 2001). Health-care providers play an essential role in controlling and alleviating these negative sequelae, as patients continually seek their reassurance and support (Rose, 1990).

Communication skills training (CST) programs have been developed to improve both health-care providers’ abilities and levels of confidence in effectively communicating with their patients (Kennedy Sheldon, 2005; Kiss & Sollner, 2006). In oncology settings, CST programs may help health-care professionals demonstrate feelings of empathy (Barth & Lannen, 2011). Furthermore, this training may help health-care professionals address stressful and difficult situations for patients and their families (Barth & Lannen, 2011). The literature has also linked CST to improved quality of medical care and improved patient satisfaction (Roter, 2006; Griffin et al., 2004).

In 2011, Barth and Lannen published a systematic review assessing the efficacy of CST for health-care professionals. They included studies with either a control group with less training compared to the intervention group or a control group with no intervention at all. They examined the health-care professional and patient outcomes of CST. The health-care professional outcomes were communication behaviors and attitudes after training. Patient outcomes were satisfaction with the communication skills of health-care professionals, as assessed by surveys. The purpose of this review is to emphasize the importance of CST, particularly in oncology patients, underlining the findings by Barth and Lannen Communication skills training is needed for health-care professionals, especially for those dealing with vulnerable populations such as oncology patients and with issues regarding palliative care and end of life. The Oncotalk program emphasizes training on those tough topics that may be challenging for both the provider and the patient (Back et al., 2007). Back and colleagues reported positive results in using the Oncotalk program to train providers to develop effective communication skills when addressing difficult issues with patients (Back et al., 2007). Communication skills training may need to be reinforced through clinical practice, didactic workshops, and/or basic training. Barth and Lannen (2011) state that continuous training throughout the course of a health-care professional’s career may improve the communication skills acquired during clinical practice. Refreshing the communication skills of health-care professionals may yield more favorable patient outcomes.

As recommended by Healthy People 2020, there is a national goal of more effective communication between health-care professionals and patients. To assess more evidence of the effectiveness of CST, studies need to be designed to measure patient outcomes before and after CST interventions. In addition, further research needs to assess both patient outcomes and health-care provider outcomes. For example, researchers should not only assess health-care professionals’ perceptions of the effectiveness of their communication skills, but they should also assess patients’ perceptions of providers’ communication skills. Effective communication is nearly as important as medical intervention in promoting healthy outcomes for oncology patients. Further research assessing the effectiveness of CST in improving the communication of health-care professionals should focus on patient outcomes rather than health-care professionals’ rating of their perceived abilities. Longitudinal studies that follow health-care professionals over time may be more beneficial in assessing the effectiveness and durability of CST and also may help meet the Healthy People 2020 goal.