DOCTOR-PATIENT COMMUNICATION AND OUTCOME IN CANCER-PATIENTS - AN INTERVENTION

Previous research suggests that the way in which doctors communicate w ith their patients has significant effects upon outcomes: ''soft'' out comes such as satisfaction and compliance with treatment regimes; and ''hard'' outcomes such as need for analgesics and length of stay in ho spital after surgical operations. The present investigation is concern ed with cancer patients and tests whether providing oncologists with a dditional training in communication may promote patients' coping, qual ity of Life and even survival. In the first part of the investigation, seventy-three patients at the University Hospital of Patras in Greece were followed for a year from the time of diagnosis. Patients were se en by the oncologist an hour or two before treatment began chemotherap y or radiotherapy - and were asked immediately after the consultation to rate the doctor's communication skills and behaviour. While there w as little evidence that communication influenced either coping or qual ity of life six to eight weeks later, there was good evidence that pat ients' reported anxiety and depression as they came out of the consult ation did have longer term effects. In the second part of the investig ation, a new set of patients were assigned to have their pre-treatment consultation under one of two conditions: in the ''experimental'' con dition doctors were trained to give information in a way that would be understood properly and would help to reduce anxiety and depression; in the ''control'' condition they received no special training and con tinued as before. The results showed that outcomes were markedly bette r in the experimental condition than the control condition, and that a reduction in anxiety and depression was the key factor.