Does psychological characteristic influence physicians' communication styles? Impact of physicians' locus of control on interviews with a cancer patient and a relative
physicians' locus of control; communication skills; patient-centred communication; interviews with a cancer patient and a relative
Abstract :
[en] 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.
Disciplines :
Public health, health care sciences & services Oncology
Author, co-author :
Libert, Yves
Merckaert, Isabelle
Reynaert, Christine
Delvaux, Nicole
Marchal, Serge
Etienne, Anne-Marie ; Université de Liège - ULiège > Département de personne et société > Psychologie de la santé
Boniver, Jacques ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques
Klastersky, Jean
Scalliet, Pierre
Slachmuylder, Jean Louis
Razavi, Darius
Language :
English
Title :
Does psychological characteristic influence physicians' communication styles? Impact of physicians' locus of control on interviews with a cancer patient and a relative
Mead N, Bower P (2000) Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med 51:1087-1110
Epstein RM, Hundert EM (2002) Defining and assessing professional competence. JAMA 287:226-235
Maguire P (1990) Can communication skills be taught? Br J Hosp Med 43:215-216
Fallowfield L, Jenkins V (1999) Effective communication skills are the key to good cancer care. Eur J Cancer 35:1592-1597
Novack DH (1987) Therapeutic aspects of the clinical interview. J Gen Intern Med 2:346-355
Bakker DA, Fitch MI, Gray R, Reed E, Bennett J (2001) Patient-health care provider communication during chemotherapy treatment: the perspectives of women with breast cancer. Patient Educ Couns 43:61-71
Maguire P (1999) Improving communication with cancer patients. Eur J Cancer 35:1415-1422
Montgomery C, Lydon A, Lloyd K (1999) Psychological distress among cancer patients and informed consent. J Psychosom Res 46:241-245
Croyle RT, Lerman C (1999) Risk communication in genetic testing for cancer susceptibility. J Natl Cancer Inst Monogr 25:59-66
Blaney PH (1986) Affect and memory: a review. Psychol Bull 99:229-246
Parle M, Maguire P, Heaven C (1997) The development of a training model to improve health professionals' skills, self-efficacy and outcome expectancies when communicating with cancer patients. Soc Sci Med 44:231-240
Rotter JB (1966) Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 80:1-28
Doherty WJ (1983) Impact of divorce on locus of control orientation in adult women: a longitudinal study. J Pers Soc Psychol 44:834-840
De Brabander B, Declerck CH (2004) A possible role of central dopamine metabolism associated with individual differences in locus of control. Pers Individ Differ 37:735-750
Libert Y, Janne P, Razavi D, Merckaert I, Scalliet P, Delvaux N, Etienne AM, Conradt S, Klastersky J, Boniver J, Reynaert C (2003) Impact of medical specialists' locus of control on communication skills in oncological interviews. Br J Cancer 88:502-509
Beisecker AE, Moore WP (1994) Oncologists' perceptions of the effects of cancer patients' companions on physician-patient interactions. J Psychosoc Oncol 12:23-39
Labrecque MS, Blanchard CG, Ruckdeschel JC, Blanchard EB (1991) The impact of family presence on the physician-cancer patient interaction. Soc Sci Med 33:1253-1261
Kurtz ME, Kurtz JC, Given CC, Given B (1996) Concordance of cancer patient and caregiver symptom reports. Cancer Pract 4:185-190
Lobchuk MM, Kristjanson L, Degner L, Blood P, Sloan JA (1997) Perceptions of symptom distress in lung cancer patients: congruence between patients and family caregivers. J Pain Symptom Manage 14:136-146
Kristjanson LJ, Nikoletti S, Porock D, Smith M, Lobchuk M, Pedler P (1998) Congruence between patients' and family caregivers' perceptions of symptom distress in patients with terminal cancer. J Palliat Care 14:24-32
Lobchuk MM, Degner LF (2002) Symptom experiences: perceptual accuracy between advanced stage cancer patients and family caregivers in the home care setting. J Clin Oncol 20:3495-3507
Pitceathly C, Maguire P (2003) The psychological impact of cancer on patients' partners and other key relatives: a review. Eur J Cancer 39:1517-1524
Toseland RW, Blanchard CG, McCallion P (1995) A problem solving intervention for caregivers of cancer patients. Soc Sci Med 40:517-528
Carnwath TC, Johnson DA (1987) Psychiatric morbidity among spouses of patients with stroke. BMJ 294:409-411
Evans RL, Bishop DS, Matlock AL, Stranahan S, Smith GG, Halar EM (1987) Family interaction and treatment adherence after stroke. Arch Phys Med Rehabil 68:513-517
Cassileth BR, Lusk EJ, Strouse TB, Miller DS, Brown LL, Cross PA (1985) A psychological analysis of cancer patients and their next-of-kin. Cancer 55:72-76
Newsom JT, Schulz R (1998) Caregiving from the recipient's perspective: negative reactions to being helped. Health Psychol 17:172-181
Greene MG, Majerovitz SD, Adelman RD, Rizzo C (1994) The effects of the presence of a third person on the physician-older patient medical interview. J Am Geriatr Soc 42:413-419
Delvaux N, Merckaert I, Marchal S, Libert Y, Conradt S, Boniver J, Etienne AM, Fontaine O, Janne P, Klastersky J, Melot C, Reynaert C, Scalliet P, Slachmuylder JL, Razavi D (2005) Physicians' communication with a cancer patient and a relative. Cancer 103:2397-2411
Gordon J, Sanson-Fisher R, Saunders NA (1988) Identification of simulated patients by interns in a casualty setting. Med Educ 22:533-538
Ainsworth MA, Rogers LP, Markus JF, Dorsey NK, Blackwell TA, Petrusa ER (1991) Standardized patient encounters: a method for teaching and evaluation. JAMA 266:1390-1396
Barrows HS (1993) An overview of the uses of standardised patients for teaching and evaluating clinical skills. Acad Med 68:443-451
Maguire P, Booth K, Elliott C, Jones B (1996) Helping health professionals involved in cancer care acquire key interviewing skills - the impact of workshops. Eur J Cancer 32A:1486-1489
Maguire P, Faulkner A, Booth K, Elliott C, Hillier V (1996) Helping cancer patients disclose their concerns. Eur J Cancer 32A:78-81
Razavi D, Delvaux N, Marchal S, De Cock M, Farvacques C, Slachmuylder JL (2000) Testing health care professionals' communication skills: the usefulness of highly emotional standardized role-playing sessions with simulators. Psychooncology 9:293-302
McKinlay JB, Lin T, Freund K, Moskowitz M (2002) The unexpected influence of physician attributes on clinical decisions: results of an experiment. J Health Soc Behav 43:92-106
Yedidia MJ, Gillespie CC, Kachur E, Schwartz MD, Ockene J, Chepaitis AE, Snyder CW, Lazare A, Lipkin M Jr (2003) Effect of communications training on medical students performance. JAMA 290:1157-1165
Booth C, Maguire P (1991) Development of a rating system to assess interaction between cancer patients and health professionals. Report to Cancer Research Campaign, London
Salehi I (1981) La théorie de l'apprentissage social de la personnalité de J. B. Rotter: le concept de lieu de contrôle du renforcement. J Thér Comport Cogn 2:103-117
May HJ, Revicki DA (1985) Professional stress among family physicians. J Fam Pract 20:165-171
Razavi D, Delvaux N, Marchal S, Bredart A, Farvacques C, Paesmans M (1993) The effects of a 24 hours psychological training programme on attitudes, communication skills and occupational stress in oncology: a randomised study. Eur J Cancer 29A:1858-1863
Silberfarb PM, Levine PM (1980) Psycho-social aspects of neoplastic disease. III Group support for the oncology nurse. Gen Hosp Psychiatry 3:192-197
Dion G, Réjean T (1994) Validation de la traduction de l'Inventaire d'Epuisement Professionnel de Maslach et Jackson. Rev Can Sci Comport 26:210-227
Maslach C, Jackson S (1986) Maslach burnout inventory: manual, 2nd edn. Consulting Psychologists Press, Palo Alto, CA
Vagg PR, Spielberger CD (1999) The Job Stress Survey: assessing perceived severity and frequency of occurrence of generic sources of stress in the work-place. J Occup Health Psychol 4:288-292
Spielberger CD, Reheiser EC (1994) The Job Stress Survey: measuring gender differences in occupational stress. J Soc Behav Pers 9:199-218
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361-370
Razavi D, Delvaux N, Farvacques C, Robaye E (1990) Screening for adjustment disorders and major depressive disorders in cancer in-patients. Br J Psychiatry 156:79-83
Wallston KA, Wallston BS (1982) Who is responsible for your health? The construct of health locus of control. In: Sanders G, Suls J (eds) Social psychology and health and illness. Erlbaum, Hillsdale, NJ, pp 65-95
Wallston KA, Stein MJ, Smith CA (1994) Form C of the MHLC scales: a condition-specific measure of locus of control. J Pers Assess 63:534-553
Karnofsky DA, Burcheval JH (1949) The clinical evaluation of chemotherapeutic agents in cancer patient. In: McLeod CM (eds) Evaluation of chemotherapeutic agents. Colombia University Press, New York
Grieco A, Lung C (1984) Investigation of the Karnofsky Performance Status as a measure of quality of life. Health Psychol 3:129-142
Delvaux N, Razavi D, Marchal S, Bredart A, Farvacques C, Slachmuylder JL (2004) Effects of a 105 hours psychological training program on attitudes, communication skills and occupational stress in oncology: a randomised study. Br J Cancer 90:106-114
Ramirez AJ, Graham J, Richards MA, Timothy AR (1996) Stress at work for the clinical oncologist. Clin Oncol 8:137-139
Steptoe A, Wardle J (2001) Locus of control and health behaviour revisited: a multivariate analysis of young adults from 18 countries. Br J Psychol 92:659-672
Wallston KA (1992) Hocus-pocus, the focus isn't strictly on locus: Rotter's social learning theory modified for health. Cogn Ther Res 16:183-199
Krause N, Stryker S (1984) Stress and well-being: the buffering role of locus of control beliefs. Soc Sci Med 18:783-790
Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R (2002) Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 359:650-656
Razavi D, Merckaert I, Marchal S, Libert Y, Conradt S, Boniver J et al (2003) How to optimise physicians' communication skills in cancer care: results of a randomised study assessing the usefulness of post training consolidation workshops. J Clin Oncol 21:3141-3149
