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Annals of Family Medicine 5:387-394 (2007)
© 2007 Annals of Family Medicine, Inc.
doi: 10.1370/afm.721
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Improving Communication Between Doctors and Breast Cancer Patients

Moira Stewart, PhD1, Judith Belle Brown, PhD1, Joanne Hammerton, MSc2, Allan Donner, PhD3, Alan Gavin, MSW4,5, Ronald L. Holliday, MD, FRCS(C)6,7, Tim Whelan, BM, BCh8, Ken Leslie, MD, FRCS(C)6, Irene Cohen, MD9, Wayne Weston, MD9 and Tom Freeman, MD9

1 Centre for Studies in Family Medicine, The University of Western Ontario, London, Ontario, Canada
2 School of Nursing, The University of Western Ontario, London, Ontario, Canada
3 Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
4 London Regional Cancer Centre, London, Ontario, Canada
5 Department of Social Work, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
6 Department of Surgery, The University of Western Ontario, London, Ontario, Canada
7 Division of General Surgery, Victoria Campus, London Health Sciences Centre, London, Ontario, Canada
8 Department of Medicine, McMaster University and Director, Supportive Cancer Care Research Unit, Juravinski Cancer Centre (formerly Hamilton Regional Cancer Centre), Hamilton, Ontario, Canada
9 Department of Family Medicine, The University of Western Ontario, London, Ontario, Canada

CORRESPONDING AUTHOR: Moira Stewart, PhD, Centre for Studies in Family Medicine, 245-100 Collip Circle, UWO Research Park, London, ON, N6G 4X8, Canada, moira{at}uwo.ca

PURPOSE We wanted to assess the effectiveness of intensive education for physicians compared with a traditional session on communicating with breast cancer patients.

METHODS A randomized controlled trial was conducted in practices in London, Hamilton, and Toronto, Canada, with 17 family physicians, 16 surgeons, and 18 oncologists, and with 102 patients of the surgeons and oncologists. Doctors were randomized to 1 of 2 continuing education approaches: a traditional 2-hour version (control group), or a new 6-hour intensive version including exploring the patients’ perspectives and reviewing videotapes and receiving feedback (intervention group). Communication behavior of the physicians was measured objectively both before and after the intervention. As well, 4 postintervention patient outcomes were measured, by design only for surgeons and oncologists: patient-centerdness of the visit, satisfaction, psychological distress, and feeling better.

RESULTS No significant differences were found on the communication score of the intervention vs the control physicians when controlling for preintervention communication scores. Intervention family physicians, however, had significantly higher communication subscores than control family physicians. Also, patients of the intervention surgeons and oncologists were significantly more satisfied (scores of 82.06 vs 77.78, P = .03) and felt better (88.2% vs 70.6%, P=.02) than patients of the control surgeons and oncologists when controlling for covariates and adjusting for clustering within doctor.

CONCLUSIONS The continuing medical education intervention was effective in terms of some but not all physician and patient outcomes.

Key Words: Breast cancer • patient-doctor relationship • communication




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TRACK Comments:

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Impact Method and Style of Communicating Information has on Breast Cancer Patients
Lillie D Shockney
Annals of Family Medicine, 26 Sep 2007 [Full text]
Importance of Educational Research
Patricia A. Carney
Annals of Family Medicine, 27 Sep 2007 [Full text]
Improving Communication
Lesley J Fallowfield
Annals of Family Medicine, 3 Oct 2007 [Full text]
Discussion of comments so far regarding Communicating wth Breast Cancer Patients
Moira Stewart
Annals of Family Medicine, 7 Oct 2007 [Full text]

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