Improving physician–patient communication about cancer pain with a tailored education-coaching intervention

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• 作者：Richard L. Street Jr. ; Christina Slee ; Donna K. Kalauokalani ; Dionne Evans Dean ; Daniel J. Tancredi ; Richard L. Kravitz
• 关键词：Physician– ; patient communication ; Cancer ; Pain ; Patient participation
• 刊名：Patient Education and Counseling
• 出版年：2010
• 出版时间：July 2010
• 年：2010
• 卷：80
• 期：1
• 页码：42-47
• 全文大小：135 K

文摘

Objective

This study examined the effect of a theoretically grounded, tailored education-coaching intervention to help patients more effectively discuss their pain-related questions, concerns, and preferences with physicians.

Methods

Grounded in social-cognitive and communication theory, a tailored education-coaching (TEC) intervention was developed to help patients learn pain management and communication skills. In a RCT, 148 cancer patients agreed to have their consultations audio-recorded and were assigned to the intervention or a control group. The recordings were used to code for patients’ questions, acts of assertiveness, and expressed concerns and to rate the quality of physicians’ communication.

Results

Patients in the TEC group discussed their pain concerns more than did patients in the control group. More active patients also had more baseline pain and interacted with physicians using participatory decision-making. Ratings of physicians’ information about pain were higher when patients talked more about their pain concerns.

Conclusions

The study demonstrates the efficacy of a theoretically grounded, coaching intervention to help cancer patients talk about pain control.

Practice implications

Coaching interventions can be effective resources for helping cancer patients communicate about their pain concerns if they are theoretically grounded, can be integrated within clinical routines, and lead to improve health outcomes.