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Annals of Oncology Advance Access originally published online on June 26, 2006
Annals of Oncology 2006 17(9):1450-1458; doi:10.1093/annonc/mdl142
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© 2006 European Society for Medical Oncology

oncology practice

Factors that influence cancer patients' anxiety following a medical consultation: impact of a communication skills training programme for physicians

A Liénard1,2, I Merckaert1,2, Y Libert1,2, N Delvaux1,5, S Marchal4, J Boniver6, A-M Etienne7, J Klastersky2, C Reynaert3, P Scalliet8, J-L Slachmuylder4 and D Razavi1,2,*

1 Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Brussels
2 Université Libre de Bruxelles, Institut Jules Bordet, Brussels
3 Université Catholique de Louvain, Faculté de Psychologie et des Sciences de l'Éducation, Louvain-la-Neuve
4 C.A.M. (Training and Research Group), Brussels
5 Hôpital Universitaire Erasme, Service de Psychologie, Brussels
6 Université de Liège, Faculté de Médecine, Liège
7 Université de Liège, Faculté de Psychologie, Liège
8 Université Catholique de Louvain, Faculté de Médecine, Brussels, Belgium

*Correspondence to: Prof. D. Razavi, Université Libre de Bruxelles, Av. F. Roosevelt, 50 – CP 191, B-1050 Bruxelles, Belgium. Tel: +32-2-650-36-16; Fax: +32-2-650-22-09; E-mail: drazavi{at}ulb.ac.be

Background: No study has yet assessed the impact of physicians' skills acquisition after a communication skills training programme on the evolution of patients' anxiety following a medical consultation. This study aimed to compare the impact, on patients' anxiety, of a basic communication skills training programme (BT) and the same programme consolidated by consolidation workshops (CW), and to investigate physicians' communication variables associated with patients' anxiety.

Patients and methods: Physicians, after attending the BT, were randomly assigned to CW or to a waiting list. The control group was not a non-intervention group. Consultations with a cancer patient were recorded. Patients' anxiety was assessed with the State Trait Anxiety Inventory before and after a consultation. Communication skills were analysed according to the Cancer Research Campaign Workshop Evaluation Manual.

Results: No statistically significant change over time and between groups was observed. Mixed-effects modelling showed that a decrease in patients' anxiety was linked with screening questions (P = 0.045), physicians' satisfaction about support given (P = 0.004) and with patients' distress (P < 0.001). An increase in anxiety was linked with breaking bad news (P = 0.050) and with supportive skills (P = 0.013). No impact of the training programme was observed.

Conclusions: This study shows the influence of some communication skills on the evolution of patients' anxiety. Physicians should be aware of these influences.

Key words: cancer, anxiety, medical consultation, communication skills, training


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