The Impact of Communication on Cancer Treatment

Effective communication is very important in a healthcare setting to ensure patient safety and minimize risk of clinical malpractice (Doyle, Lennox & Bell, 2013). This article aims to review research articles to understand the effect of communication between healthcare givers and patient as well as their families and its effect on the patient health. Five articles are chosen, each providing different perspective into the research question.

Mazor, K. M., Beard, R. L., Alexander, G. L., Arora, N. K., Firneno, C., Gaglio, B., … & Walsh, K. (2013). Patients’ and family members’ views on patient?centered communication during cancer care. Psycho?Oncology, 22(11), 2487-2495.

Patients suffering from cancer require comprehensive treatment and care. Multiple health care givers are involved in the treatment process and the ordeal impacts the psychological and physical health of both the patient and their family (Wadhwa et al., 2013). The uncertainty of the disease also negatively impacts the patient’s family. It is important to establish a proper communication with the patient the scientists conducted secondary data analysis of qualitative data of 137 patients or family members with cancer, who were interviewed and discussed about their perceptions on cancer and how the current care plan can be improved. The results showed that patients as well as their family members wanted a more sensitive approach to their care plan, any queries they have regarding the condition or care plan and understanding their mental state. This was important for the patient and their family to provide the proper cooperation. The study consists a mix of both secondary and primary data as well as effective data analysis plan which supports their research question.  
 

Curtis, J. R., Back, A. L., Ford, D. W., Downey, L., Shannon, S. E., Doorenbos, A. Z., … & Arnold, R. W. (2013). Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: a randomized trial. Jama, 310(21), 2271-2281.

This article tries to find the effect of communication skills in healthcare givers and how it affects the outcome of patients with serious illness or end of life conditions. The objective of the scientists was to assess the effectiveness of good communication skills in interventional process for administering internal medicine and its effect on patient/ family care outcome. The scientists set up a randomized clinical trial to study 391 internal medicines practitioners and 81 nursing trainees at the University of Washington and Medical University in South Carolina, from 2007 to 2013. They analyzed the trial by evaluating the results of two scenarios, reported quality of patient communication and quality of end of life care. The assessment was done in a questionnaire form, the results of which seemed somewhat average but also instances were noted where the lack of good communication skills amongst the care givers lead to depression in patients and their family members, especially in end of life conditions, where the practitioners and nurses failed to provide proper intervention based engagement. The article is quite systematic to its approach to address the research question. The primary data sample is quite high and has long observational period to collect the amount of data. The article lacks secondary data support, but the primary data analysis section is promising and the outcome seems to prove the importance of good communication skills in practitioners and nurses can provide proper care even in end of life conditions.
 

Effect of Communication Skills on End-of-Life Care

King, B. J., Gilmore?Bykovskyi, A. L., Roiland, R. A., Polnaszek, B. E., Bowers, B. J., & Kind, A. J. (2013). The consequences of poor communication during transitions from hospital to skilled nursing facility: a qualitative study. Journal of the American Geriatrics Society, 61(7), 1095-1102.

This article addresses the fact that the nursing staffs in skilled nursing facilities (SNFs) have an important responsibility in the initiation of transitional service for more than 5 million patients annually who move from hospitals-to-SNFs. The objective of the research is to evaluate how SNF nurses discharge patients admitted from healthcare facilities and the shortcomings they face in regards to patient transition. The scientists performed a qualitative study using  grounded dimensional analysis by interviewing thoroughly a selected focus group. The sample size selected were a group of 27 nursing staff in Wisconsin. The nurse’s main concern was that lack of communication during the transition affected the patient outcome and ensured 30-day readmission. The nursing staff mentioned that patients who needed critical care were discharged without any prior information or medication procedure during the process. The observations also revealed that the hospital’s lack of showing discharge history lead to serious issues during the transition. This lack of efficiency in patient transition impacted negatively on the patient as well as their families. The article proposes an important factor, but the low sample size and lack of secondary data support makes it difficult to evaluate the results.

Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., … & Lipsitz, S. R. (2014). Changes in medical errors after implementation of a handoff program. New England Journal of Medicine, 371(19), 1803-1812.

One of the leading causes behind the clinical or medication errors is the miscommunication. This article reviews the importance of communication in patient handoffs. The scientists set up interventional programs to try and improve the healthcare workflow, reduction of medication error and prevention of adverse issue in terms of effective communication (Street, 2013). The scientists performed a training program to ensure the practice of clinical handoffs in written or oral form and mapped the effects it had on patient care. The primary outcome was evaluating the amount of lowering of medication error post intervention and the prevention of adverse events.  Nine residency units were assessed in United States as well as Canada which consisted of randomized trials of a range of healthcare givers of 36 to 182 in those institutions. The post interventional survey results were evaluated using Poisson regression rule and found that out of 10,740 patient admissions, 23% decreases was observed in medical-error rate from the pre-intervention period to the post intervention period. The article was successful in getting positive results from its research outcomes and the primary data sample was a considerable amount to gain ample statistical data. The research did not take very long and was clearly established that the medication error reduction can be possible if communication is effective among healthcare givers and ensures satisfactory patient family response.
 

The Role of Communication in Patient Transition

Dudley, N., Ackerman, A., Brown, K. M., Snow, S. K., American Academy of Pediatrics Committee on Pediatric Emergency Medicine, & Emergency Nurses Association Pediatric Committee. (2015). Patient-and family-centered care of children in the emergency department. Pediatrics, 135(1), e255-e272.

The research article addresses the relationship between the healthcare giver and the patient family in a child emergency care setting. The approach of the scientists is forming an alliance model between the practitioners and patient family to provide a Patient- and family-centered care (PFCC). This mutual beneficiary partnership between patients of in this case child’s family and practitioner can provide an effective care plan consists of planning, relief, and evaluation of health care. The barriers that stand between effective communications can be overcome by providing access in times of need from the practitioners. In cases where language barrier exists, interpreter services can be arranged in order to minimize the communication gap. The family care and patient care can be ensured when in times of invasive procedures a child’s family member is allowed to stay with them (Carman et al., 2013). Communication is also essential to clearly the family’s role in the care plan and the support that they can offer in the recovery process. Patient’s family education is important to ensure that the challenges the child and their family faces during the clinical trials can be minimized and they can have a better understanding of the procedure.  Also, it is important to note that the communication between the healthcare giver and the patient family is clear during the discharge sessions to minimize the occurrence of readmission due to medication error. The article lacks primary data support but covers the major issues I literature studies and provides ample secondary data to understand the parameters of patient family engagement and heath care plan. 

Conclusion:

The above discussion makes it clear that patient safety is parallel with the communication between healthcare givers and patients as well as their families. The effective communication can improve the patient’s condition and the lack of it deteriorates the health. Miscommunication can result in multiple readmissions which may cause distress to the patient. Patient family education is also an important parameter in ensuring patient health improvement. Establishing the role of patient’s family in the improvement of health of the patient is important and only effective communication can solve this problem. Elderly patients, children and end of life patients all have certain avoidable medical errors which can be avoided with effective communication. 

References:

Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223-231.

Curtis, J. R., Back, A. L., Ford, D. W., Downey, L., Shannon, S. E., Doorenbos, A. Z., … & Arnold, R. W. (2013). Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: a randomized trial. Jama, 310(21), 2271-2281.

Doyle, C., Lennox, L., & Bell, D. (2013). A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ open, 3(1), e001570.

Dudley, N., Ackerman, A., Brown, K. M., Snow, S. K., American Academy of Pediatrics Committee on Pediatric Emergency Medicine, & Emergency Nurses Association Pediatric Committee. (2015). Patient-and family-centered care of children in the emergency department. Pediatrics, 135(1), e255-e272.

Gluyas, H. (2015). Effective communication and teamwork promotes patient safety. Nursing Standard (2014+), 29(49), 50.

King, B. J., Gilmore?Bykovskyi, A. L., Roiland, R. A., Polnaszek, B. E., Bowers, B. J., & Kind, A. J. (2013). The consequences of poor communication during transitions from hospital to skilled nursing facility: a qualitative study. Journal of the American Geriatrics Society, 61(7), 1095-1102.

Mazor, K. M., Beard, R. L., Alexander, G. L., Arora, N. K., Firneno, C., Gaglio, B., … & Walsh, K. (2013). Patients’ and family members’ views on patient?centered communication during cancer care. Psycho?Oncology, 22(11), 2487-2495.

Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., … & Lipsitz, S. R. (2014). Changes in medical errors after implementation of a handoff program. New England Journal of Medicine, 371(19), 1803-1812.

Street, R. L. (2013). How clinician–patient communication contributes to health improvement: modeling pathways from talk to outcome. Patient education and counseling, 92(3), 286-291.

Wadhwa, D., Burman, D., Swami, N., Rodin, G., Lo, C., & Zimmermann, C. (2013). Quality of life and mental health in caregivers of outpatients with advanced cancer. Psycho?Oncology, 22(2), 403-410.