Effects of an interactive tailored patient assessment tool on eliciting and responding to cancer patients' cues and concerns in clinical consultations with physicians and nurses.

Abstract

OBJECTIVE: To test the effect of Choice, an interactive tailored patient assessment tool (ITPA), on cancer patients' expressed cues and concerns (C&Cs), and clinicians' responses to these C&Cs. METHODS: 97 experimental group consultations, where patients used the Choice ITPA to report their symptoms and problems in preparation to their consultation, were compared to 99 control group consultations. All consultations were audio-taped and coded using the Verona Coding Definitions of Emotional Sequences (VR-CoDES). RESULTS: We identified 473 cues and 109 concerns with a mean number of 3.0 (SD=3.2). The most frequent utterance was cue B (45.2%), indicating expression of uncertainty or hope. We found more C&Cs in consultations with the Choice ITPA compared to the control group (p<0.01), and in consultations with nurses compared to physicians (p<0.001). No differences in clinicians' response types in the two groups were found. However, significant differences in response type between nurses and physicians were found. CONCLUSION: The Choice ITPA was an effective tool to disclose cancer patients' cues and concerns. PRACTICE IMPLICATIONS: The Choice ITPA proved to be an effective intervention for cancer patients to express more C&Cs, but should be accompanied with communication skills training to potentially produce more patient-centered responses from the clinicians. (ClinicalTrials.gov number NCT00857103.)