Computer Program in Improving Communication Between Doctors and Patients With Stage IV Cancer

OBJECTIVES:

Primary

- Determine the impact of a CD-ROM-based intervention in improving communication
behaviors between oncologists and patients with stage IV cancer.

- Compare the quality of audio-recorded conversations between oncologists and patients
with advanced cancer with best practices described in the literature, with particular
attention to communication behaviors that promote patient disclosure of concerns, use
of emotion handling skills, recognition of empathic opportunities, and the conveying of
prognostic information and compare.

- Develop an intervention to improve oncologists' communication skills in these areas
using an interactive CD-ROM based on the oncologists' own recorded discussions with
patients.

- Determine the feasibility of this intervention and, using a randomized, controlled
design, measure its effectiveness for changing physician communication behaviors and
relevant patient outcomes including reduced distress and increased satisfaction.

OUTLINE: This is a randomized, controlled, 3-part, multicenter study.

- Part 1 (baseline): Patients undergo an audio-recorded outpatient encounter with their
oncologist to see how oncologists elicit patients' concerns and respond to emotional
content. Within 1 week later, patients undergo a 10-minute interview by telephone.

- Part 2 (intervention): Oncologists are randomized to 1 of 2 arms.

- Arm I (intervention): Oncologists receive a personalized, user-friendly CD-ROM
that contains their coded conversations, packaged with related educational
material to be used for 3 months.

- Arm II (control): Oncologists do not receive a CD-ROM or any other educational
material support.

- Part 3 (post-intervention): Three months later, oncologists in both arms are reassessed
by recording another 400 clinic visits between the same oncologists and a new group of
patients to measure the intervention impact.

PROJECTED ACCRUAL: A total of 800 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

- Diagnosis of advanced cancer (stage IV disease) AND meets all of the following
criteria:

- Referred by participating physician

- Must speak English

- Receiving primary oncology care at participating centers, defined as at least 2
visits to the clinic during the past year and a future scheduled appointment

- Receiving treatment for any malignancy

- Has access to a telephone

PATIENT CHARACTERISTICS:

- Not specified

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics