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See detailAnxiety and its time courses during radiotherapy for non-metastatic breast cancer: A longitudinal study
Lewis, Florence; Merckaert, Isabelle; Liénard, Aurore et al

in Radiotherapy & Oncology (2014), 111(2), 276-280

Purpose: To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with ... [more ▼]

Purpose: To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with nonmetastatic breast cancer. Material and methods: This multicenter, descriptive longitudinal study included 213 consecutive patients with breast cancer who completed visual analog scales (VASs) assessing state anxiety before and after the RT simulation and the first and last five RT sessions. Results: Pre- and post-session anxiety mean levels were highest at the RT simulation (respectively, 2.9 ± 2.9 and 1.6 ± 2.5) and first RT session (respectively, 3.4 ± 2.9 and 2.0 ± 2.4), then declined rapidly. Clinically relevant mean differences (P1 cm on the VAS) between pre- and post-simulation/session VAS scores were found only for the RT simulation ( 1.3 ± 2.7; p < 0.001) and first RT session ( 1.4 ± 2.4; p < 0.001). Five percent to 16% of patients presented clinically relevant anxiety (pre- and post-simulation/session VAS scoresP4 cm) throughout treatment. Conclusions: To optimize care, RT team members should offer all patients appropriate information about treatment at the simulation, check patients’ understanding, and identify patients with clinically relevant anxiety requiring appropriate support throughout RT. [less ▲]

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See detailThe effect of communication skills training on residents' physiological arousal in a breaking bad news simulated task
Meunier, Julie; Merckaert, Isabelle; Libert, Yves et al

in Patient Education & Counseling (2013), 93(1), 40-47

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See detailIs it possible to improve radiotherapy team members’ communication skills. A randomized study assessing the efficacy of a 38h communications skills training program
GIBON, Anne-Sophie; MERCKAERT, Isabelle; LIENARD, Aurore et al

in Radiotherapy & Oncology (2013), 109(1), 170177

Background and purpose: Optimizing communication between radiotherapy team members and patients and between colleagues requires training. This study applies a randomized controlled design to assess the ... [more ▼]

Background and purpose: Optimizing communication between radiotherapy team members and patients and between colleagues requires training. This study applies a randomized controlled design to assess the efficacy of a 38-h communication skills training program. Material and methods: Four radiotherapy teams were randomly assigned either to a training program or to a waiting list. Team members’ communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient were the primary endpoints. These encounters were scheduled at the baseline and after training for the training group, and at the baseline and four months later for the waiting list group. Encounters were audiotaped and transcribed. Transcripts were analyzed with content analysis software (LaComm) and by an independent rater. Results: Eighty team members were included in the study. Compared to untrained team members, trained team members used more turns of speech with content oriented toward available resources in the team (relative rate [RR] = 1.38; p = 0.023), more assessment utterances (RR = 1.69; p < 0.001), more empathy (RR = 4.05; p = 0.037), more negotiation (RR = 2.34; p = 0.021) and more emotional words (RR = 1.32; p = 0.030), and their self-efficacy to communicate increased (p = 0.024 and p = 0.008, respectively). Conclusions: The training program was effective in improving team members’ communication skills and their self-efficacy to communicate in the context of an encounter with a simulated patient. Future study should assess the effect of this training program on communication with actual patients and their satisfaction. Moreover a cost-benefit analysis is needed, before implementing such an intensive training program on a broader scale. [less ▲]

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See detailLes fonctions cognitives au commencement d’une nouvelle ligne de traitement chez des patients âgés atteints d’un cancer hématologique
Jonius, Bénédicte; Libert, Yves; Bragard, Isabelle ULg et al

in Psycho-Oncologie (2013), 7(2), 118-129

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See detailIs it possible to improve the breaking bad news skills of residents when a relative is present? A randomised study.
Merckaert, Isabelle; Liénard, Aurore; Libert, Yves et al

in British Journal of Cancer (2013), 109

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See detailCommunication skills training for residents:which variables predict learning of skills?
Bragard, Isabelle ULg; Merckaert, Isabelle; Libert, Yves et al

in Open Journal of Medical Psychology (2012), 1

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See detailPredictors and correlates of burnout in residents working with cancer patients
Bragard, Isabelle ULg; Etienne, Anne-Marie ULg; Libert, Yves et al

in Journal of Cancer Education (2010)

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See detailCommunication skills training: A study of residents' psychosocial and physiological variables which facilitate or inhibit the learning of assessment skills
Hasoppe, Jennifer; Merckaert, Isabelle; Libert, Yves et al

in Psycho-oncology (2009, June)

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See detailPredictors and correlates of changes in residents' burnout level: Influence of person- and work-related variables
Bragard, Isabelle ULg; Etienne, Anne-Marie ULg; Libert, Yves et al

in Psycho-oncology (2009, June), 18 (Suppl. 2)

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See detailPhysicians are different when they learn communication skills: influence of the locus of control
Libert, Yves; Merckaert, I.; Reynaert, C. et al

in Psycho-Oncology (2007), 16(6), 553-562

Purpose: Although it is widely recognised that educational interventions may be more effective for people with an 'internal' Locus of Control (who believe that life outcomes are controlled by their own ... [more ▼]

Purpose: Although it is widely recognised that educational interventions may be more effective for people with an 'internal' Locus of Control (who believe that life outcomes are controlled by their own characteristics or actions) compared to people with an 'external' Locus of Control (who believe that life outcomes are controlled by external forces such as luck, fate or others), no study has yet assessed the influence of physicians' Locus of Control (LOC) on communication skills learning. This study aims to test the hypothesis that, in a communication skills training program, physicians with an 'internal' LOC would demonstrate communication skills acquisition to a greater degree than those with an 'external' LOC. Methods: A non-randomised longitudinal intervention study was conducted between January 1999 and April 2001. Sixty-seven volunteer physicians from private and institutional practice in Belgium participated in a learner-centred, skills-focused, practice-oriented communication skills training program. Communication skills changes were assessed in 2 standardised simulated interviews before and after training (one two-person and one three-person interview). Communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians' LOC was assessed using the Rotter I-E scale. Communication skills changes of the upper and lower third of physicians in respect of their scores on this scale were compared using group by time repeated measures of variance. Results: In the two-person and three-person interviews, changes in the use of open directive questions were more important among physicians with an "internal" LOC compared with changes observed among physicians with an 'external' LOC (P = 0.066 and P = 0.004, respectively). In the three-person interview, changes in the use of directive questions, assessing functions and moderate feelings stated explicitly were more important among physicians with an 'internal' LOC compared with changes observed among physicians with an 'external' LOC (P = 0.001; P = 0.002 and P = 0.011 respectively). Conclusion: This study shows that physicians' LOC is a psychological characteristic that could influence the efficacy of a communication skills training program. This evidence supports the idea that a psychological characteristic such as 'internal' LOC may facilitate communication skills acquisition through physicians' belief that communication with patients may be controlled by physicians themselves. Copyright (c) 2006 John Wiley [less ▲]

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See detailFactors that influence physicians' burnout: Impact of a communication skills training program
Bragard, Isabelle ULg; Libert, Yves; Merckaert, Isabelle et al

in Psycho-Oncology (2006, October), 15(2, Suppl. S), 183-184

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See detailFactors that influence cancer patients' anxiety following a medical consultation: impact of a communication skills training programme for physicians
Lienard, Aurore; Merckaert, Isabelle; Libert, Yves et al

in Annals of Oncology (2006), 17(9), 1450-1458

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 ... [more ▼]

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. [less ▲]

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See detailDoes psychological characteristic influence physicians' communication styles? Impact of physicians' locus of control on interviews with a cancer patient and a relative
Libert, Yves; Merckaert, Isabelle; Reynaert, Christine et al

in Supportive Care in Cancer (2006), 14(3), 230-242

Context: Physicians' psychological characteristics may influence their communication styles and may thus interfere with patient-centred communication. Objective: Our aim was to test the hypothesis that ... [more ▼]

Context: Physicians' psychological characteristics may influence their communication styles and may thus interfere with patient-centred communication. Objective: Our aim was to test the hypothesis that, in interviews with a cancer patient and a relative, physicians with an "external" locus of control (LOC; who believe that life outcomes are controlled by external forces such as luck, fate or others) have a communication style different from that of physicians with an "internal" LOC (who believe that life outcomes are controlled by their own characteristics or actions). Design, setting, participants and intervention: Eighty-one voluntary physicians practising in the field of oncology were recorded while performing an actual and a simulated interview with a cancer patient and a relative. Main outcome measures: Physicians' communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians' LOC was assessed using the Rotter I-E scale. The communication skills of the upper and lower quartiles of physicians in respect of their scores on this scale were compared using Student's t test. Results: In actual interviews, physicians with an "external" LOC talked more to the relative (P=0.017) and used more utterances with an assessment function (P=0.010) than physicians with an "internal" LOC. In simulated interviews, physicians with an "external" LOC used less utterances that give premature information (P=0.031) and used more utterances with a supportive function, such as empathy and reassurance (P=0.029), than physicians with an "internal" LOC. Conclusion: These results provide evidence that physicians' LOC can influence their communication styles. Physicians' awareness of this influence constitutes a step towards a tailoring of their communication skills to every patient's and relative's concerns and needs and thus towards a patient-centred communication. [less ▲]

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See detailTeaching communication and stress management skills to junior physicians dealing with cancer patients: a Belgian Interuniversity Curriculum
Bragard, Isabelle ULg; Razavi, Darius; Marchal, Serge et al

in Supportive Care in Cancer (2006), 14(5), 454-461

Background: Ineffective physicians' communication skills have detrimental consequences for patients and their relatives, such as insufficient detection of psychological disturbances, dissatisfaction with ... [more ▼]

Background: Ineffective physicians' communication skills have detrimental consequences for patients and their relatives, such as insufficient detection of psychological disturbances, dissatisfaction with care, poor compliance, and increased risks of litigation for malpractice. These ineffective communication skills also contribute to everyday stress, lack of job satisfaction, and burnout among physicians. Literature shows that communication skills training programs may significantly improve physicians' key communication skills, contributing to improvements in patients' satisfaction with care and physicians' professional satisfaction. This paper describes a Belgian Interuniversity Curriculum (BIC) theoretical roots, principles, and techniques developed for junior physicians specializing in various disciplines dealing with cancer patients. Curriculum description: The 40-h training focuses on two domains: stress management skills and communication skills with cancer patients and their relatives. The teaching method is learner-centered and includes a cognitive, behavioral, and affective approach. The cognitive approach aims to improve physicians' knowledge and skills on the two domains cited. The behavioral approach offers learners the opportunity to practice these appropriate skills through practical exercises and role plays. The affective approach allows participants to express attitudes and feelings that communicating about difficult issues evoke. Such an intensive course seems to be necessary to facilitate the transfer of learned skills in clinical practice. Conclusions: The BIC is the first attempt to bring together a stress management training course and a communication training course that could lead not only to communication skills improvements but also to burnout prevention. [less ▲]

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See detailLes besoins psychosociaux et le soutien apporté aux patients atteints d'un cancer : une étude nationale belge
Libert, Yves; Merckaert, Isabelle; Etienne, Anne-Marie ULg et al

in Oncologie (2006), (8), 465-476

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See detailManuel de formation à la gestion du stress et à la communication avec des patients cancéreux et leurs proches
Etienne, Anne-Marie ULg; Bragard, Isabelle ULg; Libert, Yves et al

in CHASSEIGNE, Gérard (Ed.) Stress, santé, société (2006)

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See detailFactors that influence physicians' detection of distress in patients with cancer - Can a communication skills training program improve physicians' detection?
Merckaert, Isabelle; Libert, Yves; Delvaux, Nicole et al

in Cancer (2005), 104(2), 411-421

BACKGROUND. No study to date has assessed the impact of skills acquisition after a communication skills training program on physicians' ability to detect distress in patients with cancer. METHODS. First ... [more ▼]

BACKGROUND. No study to date has assessed the impact of skills acquisition after a communication skills training program on physicians' ability to detect distress in patients with cancer. METHODS. First, the authors used a randomized design to assess the impact, on physicians' ability to detect patients' distress, of a 1-hour theoretical information course followed by 2 communication skills training programs: a 2.5-day basic training program and the same training program consolidated by 6 3-hour consolidation workshops. Then, the investigate contextual, patient, and communication variables or factors associated with physicians' detection of patients' distress were investigated. After they attended the basic communication skills training program, physicians were assigned randomly to consolidation workshops or to a waiting list. Interviews with a cancer patient were recorded before training, after consolidation workshops for the group that attended consolidation workshops, and approximate to 5 months after basic training for the group that attended basic training without the consolidation workshops. Patient distress was recorded with the Hospital Anxiety and Depression Scale before the interviews. Physicians rated their patients' distress on a visual analog scale after the interviews. Physicians' ability to detect patients' distress was measured through computing differences between physicians' ratings of patients' distress and patients' self-reported distress. Communication skills were analyzed according to the Cancer Research Campaign Workshop Evaluation Manual. RESULTS. Fifty-eight physicians were evaluable. Repeated -measures analysis of variance showed no statistically significant changes over time and between groups in physicians' ability to assess patient distress. Mixed-effects modeling showed that physicians' detection of patients' distress was associated negatively with patients' educational level (P = 0.042) and with patients' self-reported distress (P < 0.000). Mixed-effects modeling also showed that physicians' detection of patient distress was associated positively with physicians breaking bad news (P = 0.022) and using assessment skills (P = 0.015) and supportive skills (P = 0.045). CONCLUSIONS. Contrary to what was expected, no change was observed in physicians' ability to detect distress in patients with cancer after a communication skills training programs, regardless of whether physicians attended the basic training program or the basic training program followed by the consolidation workshops. The results indicated a need for further improvements in physicians' detection skills through specific training modules, including theoretical information about factors that interfere with physicians' detection and through role-playing exercises that focus on assessment and supportive skills that facilitate detection. (c) 2005 American Cancer Society. [less ▲]

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