Handbook of Communication in Oncology and Palliative Care

ABOUT THIS BOOK

• The dedicated communication skills training curriculum details key steps, processes and tasks that optimize communication
• The historical, theoretical, evidence-based and experiential aspects of the book offer a practical guide across a gamet of difficult clinical predicaments
• Superb tables give multiple clinical examples, illustrating how to communicate well
• Research-oriented chapters assist the academic in empirical studies

This comprehensive text provides clinicians with practical and evidence-based guidelines to achieve effective, patient-centered communication in the areas of cancer and palliative care. Written by an outstanding panel of international experts, it integrates empirical findings with clinical wisdom, draws on historical approaches and presents a state-of-the-art curriculum for applied communication skills training for the specialist oncologist, surgeon, nurse and other multi-disciplinary team members involved in cancer care today.

In this book communication is broken down into key modules that cover the life-cycle of cancer care. They include coverage of diagnosis and treatment including clinical trials, empathic support in response to distress, transition to survivorship or palliative therapies, discussion of prognosis, conduct of family meetings, and care of the dying. Complementary training of patients in their communication with the doctor completes the interactive dyad. The art of teaching, impact of gender and power in the consultation and the ethical context are carefully considered.

Special communication challenges include discussion of genetic risk, rehabilitative and salvage surgery, promotion of treatment adherence, unanticipated adverse outcomes, intercultural issues, fertility and sexuality. The value of decision aides, question prompt lists, audio-recording of consultations and use of the internet is illustrated.
By looking across the full spectrum of disciplines involved in the multidisciplinary team, discipline-specific issues are considered by experts in each field. In this manner, the needs of patients and their relatives are evaluated, including paediatric and geriatric populations. To achieve all of this, theoretical models are examined from the medical school to the highly specialized practice, facilitation training and actor training are made explicit, and international approaches to communication skills training are compared and contrasted. Finally, research tools that assist in coding cancer consultations, evaluating training courses, and employing mixed methods in studies aid the reader in providing clear and sensitive communication when handling challenging situations whilst treating cancer sufferers and palliative care patients.

Readership: This book will appeal to oncology specialists (including surgeons, medical and radiation oncologists, clinical oncologists and palliative care physicians), nurses, allied health practitioners, social workers, psychologists and psychiatrists, general practitioners and pastoral care workers, trainees, researchers, as well as advocacy groups and the intelligent lay public.

TABLE OF CONTENTS

Section A: Introduction to communication studies in cancer and palliative medicine
1: Mack Lipkin: The history of communications skills knowledge and training
2: Stewart M Dunn: The art of teaching communication skills
3: Richard Brown and Carma Bylund: Theoretical models of communication skill training
4: Cathy Charles and Amiram Gafni: Shared treatment decision-making and the use of decision aids
5: Laura A Siminoff: The ethics of communication in cancer and palliative care
6: Marianne Schmid Mast, Christina Klöckner and Judith A. Hall: Gender, power and nonverbal communication
7: Joshua Hauser & Gregory Makoul: Medical student training in communication skills
8: Donald J. Cegala & Dana Eisenberg: Overview of interventions to enhance cancer patients' participation in medical consultations

Section B: A core curriculum for communication skills training for oncology and palliative care
9: Walter F. Baile and Patricia A. Parker: Breaking bad news
10: Phyllis N Butow, Martin NH Tattersall & Martin Stockler: Discussing prognosis and communicating risk
11: David W Kissane: Communication training to achieve shared treatment decisions
12: Jennifer Philip and David W Kissane: Responding to difficult emotions
13: Linda Sheahan and Simon Wein: Denial and communication
14: Terrance L. Albrecht, Susan S. Eggly, John C. Ruckdeschel: Communicating with relatives/companions about cancer care
15: Nessa Coyle & David W Kissane: Conducting a family meeting
16: Linda E. Carlson & Barry D. Bultz: Communication about coping as a survivor
17: Lidia Schapira: Dealing with cancer recurrence
18: Josephine M. Clayton & David W. Kissane: Communication about transitioning patients to palliative care
19: Tomer Levin & Joseph S. Weiner: End-of-life communication training

Section C: A specialty curriculum for oncology
20: Richard Brown & Terrance Albrecht: Enrolment in clinical trials
21: Jane Turner: Working as a multidisciplinary team
22: Elizabeth Lobb & Clara Gaff: Communicating genetic risk
23: Andrea Pusic, Rachel Bell & Diana Harcourt: Rehabilitative and salvage surgery
24: Penelope Schofield, Justine Diggens, Sue Hegarty, Catherine Charleson, Rita Marigliani, Caroline Nehill & Michael Jefford: Discussing unproven therapies
25: Carma L. Bylund & Jennifer A. Gueguen: The effect of internet use on the doctor-cancer patient relationship
26: Kelly Haskard & M. Robin DiMatteo: Promoting treatment adherence
27: Melanie Lovell & Frances Boyle: Communication strategies and skills for optimum pain control
28: Thomas Gallagher and Afaf Girgis: Discussing adverse outcomes with patients
29: Martin Tattersall: Clinical perspectives on shared decision-making
30: Thomas F. Hack & Lesley F. Degner: Audio-recording important consultations for patients and their familities - putting evidence into practice
31: Steven Klimidis & Harry Minas: Working with interpreters and achieving culturally competent communication
32: Bejoy C. Thomas, Joshua J. Lounsberry & Linda E. Carlson: Challenges in communicating with ethnically diverse populations
33: James Hallenbeck & Vyjeyanthi S. Periyakoil: Intercultural communication in palliative care
34: Zeev Rosberger, Jeanne Carter, Marie Achille, Barry Bultz & Peter Chan: Communicating about infertility risks
35: John W. Robinson & Joshua J. Lounsberry: Communicating about sexuality in cancer care

Section D: Communication issues across the disciplines
36: Sandra Winterburn & Susie Wilkinson: The challenges and rewards of communication skills training for oncology and palliative care nurses in the United Kingdom
37: Anthony De La Cruz, Richard Brown & Steve Passik: Ambulatory nurses responding to depression
38: Carrie Lethborg & Grace Christ: Social work support in crisis
39: Kim Feigin & Laura Liberman: Communication in radiology
40: Alexandra Heerdt, Bernard Park & Patrick Boland: Communication in surgical oncology
41: Lai Cheng Yew & Jane Maher: Communication in non-surgical oncology
42: Ilora Finlay: Palliative medicine: communication to promote life near the end-of-life
43: Peter Speck & Christopher Herbert: Communication issues in pastoral care and chaplaincy
44: Venetia Bourrier & Brent Schacter: Communication in oncology pharmacy: the challenge of the treatment adherence
45: Barry D. Bultz, Paul B. Jacobsen & Matthew Loscalzo: Psychosocial program development
46: Ron Adelman & Michelle Green: Communication challenges with the elderly
47: Andrew Roth & Christian Nelson: Issues for cognitively impaired elderly patients
48: Cynthia W. Moore, Michele Pengelly & Paula Rauch: Communicating with children when a parent is dying
49: Marilyn Hundleby, Kate Collie & Linda E. Carlson: Creative arts in oncology

Section E: Education and training
50: Suzanne Kurtz & Lara Cooke: Learner-centered communication
51: Carma L. Bylund, Richard Brown, Barbara Lubrano di Ciccone & Lyuba Konopasek: Facilitating skills practice in communication role play sessions: essential elements and training facilitators
52: Paul Heinrich: The role of the actor in medical education
53: Carma Bylund, thomas D'Agostino & Betty Chewning: Training patients to reach their communication goals: a concordance perspective

Section F: International initiatives in communication training
54: Robert Arnold, Anthony Back, Kelly Fryer-Edwards & Walter Baile: The OncoTalk model
55: F. Stiefel, J. Bernhard, G. Bianchi, L. Dietrich, Ch. Hürny, A. Kiss & B Wössmer: The Swiss model
56: Caroline Nehill & Alison Evans: The Australian model
57: Simon Noble, Nicola Pease & Ilora Finlay: The United Kingdom general practitioner and pallaitve care model
58: Isabelle MErckaert, Yves Libert & Darius Razavi: Communication skills training and research: the Brussels experience

Section G: Research in cancer communication
59: Lyuba Konopasek, Marcy Rosenbaum, John Encandela & Kathy Cole-Kelly: Evaluating communication skills training courses
60: Felicia Roberts: Qualitative approaches to clinician-patient communication
61: Phyllis Butow & Sarah Ford: Doctor-patient communication interaction analysis systems
62: Debra Roter: The Roter Interaction Analysis System (RIAS): applicability within the context of cancer and palliative care

AUTHOR INFORMATION

Edited by David Kissane, Jimmie C. Holland Chair in Psycho-Oncology, Attending Psychiatrist and Chairman, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center; Professor of Psychiatry, Weill Medical College of Cornell University, New York, NY, USA, Barry Bultz, Director, Department of Psychosocial Resources, Program Leader: Psychosocial Oncology, Supportive, Pain and Palliative Care, Tom Baker Cancer Centre, and Chair and Adjunct Professor, Division of Psychosocial Oncology, Department of Oncology, University of Calgary, Canada, Phyllis Butow, Professor, NHMRC Principle Research Fellow, and Chair of the Australian Psycho-Oncology Co-operative Research Group, School of Psychology, University of Sydney, Australia, and Ilora Finlay, Professor, Cardiff University; Consultant in Palliative Medicine, Velindre Hospital, Cardiff; Independent Crossbench member, House of Lords, Westminster, London, UK

David Kissane began teaching physician-patient communication skills to Monash University medical students in Australia in the early 1980s and then incorporated experiential training into the subject Psycho-Oncology within the Postgraduate Diplomas of Palliative Medicine and Psycho-Oncology that he initiated in 1996 at the University of Melbourne during his tenure as foundation Professor and Director of Palliative Medicine. He is currently the incumbent in the Jimmie C. Holland Chair of Psycho-Oncology and Chairman of the Department of Psychiatry and Behavioral Sciences at Memorial Sloan-Kettering Cancer Center in New York. He is thus an Attending Psychiatrist at The Memorial Hospital for Cancer and Allied Diseases, and Professor of Psychiatry at the Weill Medical College of Cornell University. Across his 35-year medical career, he has trained in family medicine, psychiatry of the medically ill and palliative medicine. Dr. Kissane is the author of over 175 publications.

Barry Bultz became Director in 1981 of the Department of Psychosocial Resources at the Tom Baker Cancer Center in Calgary, Alberta, where he has subsequently developed and leads one of the first interdisciplinary psychosocial oncology programs in Canada - Psychosocial Oncology, Supportive, Pain and Palliative Care. As a founding member and Past President of the Canadian Association of Psychosocial Oncology (CAPO), he has been an active member of the Canadian Consortium on Communication Skills Training. He is internationally regarded for the concept of emotional distress as the 6th vital sign and chaired the 1st Canadian conference in Psychosocial Oncology in 1985 and the 6th World Congress of Psycho-Oncology in 2003. He is also holds faculty appointments in Oncology, Psychiatry, Surgery and Psychology. He is the author of over 100 scholarly publications and serves on several editorial boards for cancer-related journals.

Phyllis Butow is currently Professor and National Health and Medical Research Council Principal Research Fellow in the School of Psychology, University of Sydney, where she co-directs the Centre for Medical Psychology and Evidence-based Medicine (CeMPED). She has worked in Psycho-Oncology for over 16 years, currently chairs the newly established Australian Psycho-Oncology Co-operative Research Group and has developed an international reputation in Health Communication. She developed a curriculum in communication skills for the University of Sydney medical program, chairs the National Breast and Ovarian Cancer Centre (NBOCC) Communication Skills Working Party, was a Principal Investigator on one national and one international randomized controlled trial of communication skills training, and has facilitated hundreds of communication skills courses for the NBOCC and the Pam McLean Cancer Communications Centre over the past 10 years. Prof Butow has over 200 publications in peer reviewed journals.

Ilora Finlay is a Consultant in Palliative Medicine and chronic pain at the Velindre NHS Trust, Cardiff. She is also an honorary Professor and was Vice Dean of the School of Medicine 2000-2005. Professor Finlay currently chairs the Palliative Care Strategy Implementation Board for the Welsh Assembly Government. She has published over 126 papers and seven books and holds senior editorial positions for medical journals such as Lancet Oncology and the Journal of Evaluation in Clinical Practice. In 1996, Baroness Finlay was named Welsh Woman of the Year in recognition for her work in the field of palliative care. In 2001, she was appointed a people's peer in the first open contest for membership of the House of Lords. In establishing the Diploma/MSc in Palliative Medicine (Cardiff University), she has trained hundreds of general practitioners in communication skills through experiential residential programmes, developing teaching tools and assessment methods.

Contributors:
Mack Lipkin, Professor, Department of Medicine, New York University Medical Center, USA
Stewart M Dunn, Professor of Psychological Medicine, Royal North Shore Hospital, The University of Sydney, Australia
Richard Brown, Assistant Attending Behavioral Scientist, Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
Carma Bylund, Assistant Attending Behavioral Scientist, Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA
Cathy Charles, Professor, Health Sciences Centre, McMaster University, Ontario, Canada
Amiram Gafni, Health Sciences Centre, McMaster University, Ontario, Canada
Laura A Siminoff, Professor and Chair, Social & Behavioral Health, Virginia Commonwealth University, Richmond, USA
Marianne Schmid Mast, University of Neuchatel, Switzerland
Christina Klöckner, University of Neuchatel, Switzerland
Judith A. Hall, Social Psychologist, Department of Psychology, Northeastern University, Boston, USA
Joshua Hauser, Assistant Professor, MED-Buehler Center on Aging, Northwestern University, Chicago, USA
Gregory Makoul, Professor and Director, Center for Communication & Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA
Donald J. Cegala, Professor of Communication & Family Medicine, Ohio State University, Columbus, USA
Dana Eisenberg, Ohio State University, Columbus, USA
Walter F. Baile, Professor, Behavioral Science; Director, Program in Interpersonal Communication and Relationship Enhancement ( I*CARE), University of Texas M.D. Anderson Cancer Center, Houston, USA
Patricia A. Parker, University of Texas M.D. Anderson Cancer Center, Houston, USA
Phyllis N Butow, Professor and Co-Director, Centre for Medical Psychology and Evidence-based Medicine (CeMPED), School of Psychology, University of Sydney, Australia
Martin NH Tattersall, Professor of Cancer Medicine, Cancer Medicine Research and Teaching, Discipline of Medicine, University of Sydney, Australia
Martin Stockler, NHMRC Clinical trials, University of Sydney, Australia
David W Kissane, Jimmie C. Holland Chair in Psycho-Oncology, Attending Psychiatrist and Chairman, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center; Professor of Psychiatry, Weill Medical College of Cornell University, New York, USA
Jennifer Philip, Consultant, Palliative Care Service, Monash Medical School - Alfred Hospital, Prahran, Australia
Linda Sheahan, Peter MacCallum Cancer Centre, Melbourne, Australia
Simon Wein, Peter MacCallum Cancer Centre, Melbourne, Australia
Terrance L. Albrecht, Program Leader, Communication & Behavioral Oncology Program, Karmanos Cancer Institute, Detroit, USA
Susan S. Eggly, Wayne State University - Medicine, Karmanos Cancer Institute, Detroit, USA
John C. Ruckdeschel, Director, Karmanos Cancer Institute, Detroit, USA
Nessa Coyle, Neurology, Memorial Sloan-Kettering Cancer Center, New York, USA