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Kommunikation in der Onkologie

Communication in oncology

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Zusammenfassung

Die Patient-Arzt-Kommunikation ist für die Krankheitsverarbeitung und das Krankheitserleben von Krebspatienten eine wesentliche Determinante. Im „Kommunikationszeitalter“ wird Information und Datenübertragung häufig bereits mit Kommunikation gleichgesetzt. Im Gegensatz zu analogem oder digitalem Informationsaustausch ist jedoch die Botschaft, die in der personalen Kommunikation beim Gesprächspartner „ankommt“, oft sehr unterschiedlich von der, die intendiert war, weil nonverbale und emotionale Kontextmerkmale die Informationsperzeption, -interpretation und -verarbeitung entscheidend modulieren. Eine in der modernen Onkologie zunehmende Inkongruenz auf Patientenseite von Krankheitserleben und diagnostizierter Krankheit kompliziert die Patient-Arzt-Kommunikation zudem. Jedes ärztliche Gespräch wird nur befriedigend sein, wenn sein Inhalt, sein Setting und seine Struktur an einer konkreten Zielsetzung ausgerichtet sind. Empirisch abgesichert, lassen sich die Elemente einer guten Patient-Arzt-Kommunikation mit beidseitigem Nutzen lehren und nachhaltig lernen.

Abstract

Patient-doctor communication is an essential aspect of coping with cancer. In our “age of communication”, information and data transfer often is mistaken for communication. Contrary to analogous or digital information transmission, a message received by the patient may widely differ from the message intended by the doctor. For in human communication, nonverbal and emotional contexts may extensively modify the perception, interpretation and processing of information. Moreover, in modern oncology patient-doctor communication is complicated by a growing incongruence between a patient’s disease and his illness experience. To achieve satisfying doctor-patient communication, the setting, content and structure have to be directed towards a specific goal. Empirical data show that key elements and skills of efficient patient-doctor communication can be taught and learned.

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Literatur

  1. Buckman R, Baile W (1998) How to break bad news to patients with cancer: a practical protocol for clinicians. ASCO Education book (Spring), pp 203–208

    Google Scholar 

  2. Fallowfield L, Jenkins V, Farewell V et al. (2002) Efficacy of a cancer research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 359, 650–656

    Google Scholar 

  3. Fallowfield L, Lipkin M, Hall A (1998) Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol 16:1961–1968

    CAS  PubMed  Google Scholar 

  4. Fogarty L, Curbow B, Wingard J et al. Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol 17:371–379

  5. Ford S, Fallowfield L, Lewis S (1994) Can oncologists detect distress in their out-patients and how satisfied are they with their performance during bad news consultations? Br J Cancer 70:767–770

    CAS  PubMed  Google Scholar 

  6. McGrath P (2004) The burden of the „RA RA“ positive: survivors‘ and hospice patients‘ reflections on maintaining a positive attitude to serious illness. Support Care Cancer 12:25–33

    PubMed  Google Scholar 

  7. Heller A (1994) Kultur des Sterbens. Bedingungen um das Lebensende zu gestalten. Lambertus, Freiburg i. B., S 124.

  8. Jenkins V, Fallowfield L (2002) Can communication skills training alter physicians‘ beliefs and behaviour in clinics? J Clin Onco 20:765–769

    Article  Google Scholar 

  9. Kappauf H, Leykauf-Ammon D, Bruntsch U et al. (2000) Use of and attitudes towards unconventional medicine by patients in a department of internal medicine / oncology and haematology. Support Care Cancer 8:314–322

    Article  CAS  PubMed  Google Scholar 

  10. Kappauf H (2001) Aufklärung und Hoffnung—Ein Widerspruch? Z Palliativmed 2:47–51

    Article  Google Scholar 

  11. Kerr J, Engel J, Schlesinger-Raab A et al. (2003) Communication, quality of life and age: results of a 5-year prospective study in breast cancer patients. Ann Oncol 14:423–427

    Google Scholar 

  12. Keller M, Kappauf H (2002) In die Wiege gelegt? Kommunikationskompetenz von Ärzten. Forum DKG 05/02:23–26

    Google Scholar 

  13. Kurtz S, Silverman J, Draper J (1998) Teachng and learning communication skills in medicine. Radcliff Medical Press, Oxon

  14. Langwitz WA, Eich P, Kiss A, Wössner B (1998) Improving communication skills—a randomized controlled behaviorally oriented intervention study for residents in internal medicine. Psychosom Med 60:268–276

    PubMed  Google Scholar 

  15. Maguire P, Pitceathly C (2002) Key communication skills and how to acquire them. Br Med J 325:697–700

    Article  Google Scholar 

  16. Maguire P (2000) Communication with terminally ill patients and their relatives. In: Chochinov HM, Breitbart W (eds) Handbook of psychiatry in palliative medicine. Oxford Univ. Press, New York, pp 291–301

  17. Maguire P (1999) Improving communication with cancer patients. Eur J Cancer 35:2058–2065

    Article  CAS  PubMed  Google Scholar 

  18. Maguire P, Booth K, Elliott C, Jones B (1995) Helping health professionals involved in cancer care acquire key interviewing skills—the impact of workshops. Eur J Cancer 32A:1486–1489

    Google Scholar 

  19. Newell S, Sanson-Fisher R, Girgis A, Bonaventura A (1998) How well do medical oncologists‘ perceptions reflect their patients‘ reported physical and psychosocial problems? Data from a survey of five oncologists. Cancer 83:1640–1651

    Article  CAS  PubMed  Google Scholar 

  20. 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

    Article  CAS  PubMed  Google Scholar 

  21. Ptacek JT, Ptacek J (2001) Patients‘ perceptions of receiving bad news about cancer. J Clin Oncol 19:4160–4164

    CAS  PubMed  Google Scholar 

  22. Rabinowitz I, Luzzatti R, Tamir A, Reis S (2004) Length of patient’s monologue, rate of completion, and relation to other components of the clinical encounter: observational intervention study in primary care. Br Med J 328:501–502

    Article  Google Scholar 

  23. Ramirez A, Graham J, Richards M et al. (1995) Burnout and psychiatric disorder among cancer clinicians. Br J Cancer 71:1263–1269

    CAS  PubMed  Google Scholar 

  24. Razavi D, Delvaux N (1997) Communication skills and psychological training in oncology. Eur J Cancer 33 [Suppl 6]:15–21

    Google Scholar 

  25. Roter D, Hall J, Kern D et al. (1995) Improving physicians‘ interviewing skills and reducing patients‘ emotional distress. A randomized clinical trial. Arch Intern Med 155:1877–1884

    Article  CAS  PubMed  Google Scholar 

  26. Sardell AN, Trierweiler SJ (1993) Disclosing the cancer diagnosis. Procedures that influence patient hopefulness. Cancer 72:3355–3365

    CAS  PubMed  Google Scholar 

  27. Schofield PE et al. (2003) Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 14:48–56

    Article  CAS  PubMed  Google Scholar 

  28. Soellner W, DeVries A, Steixner E et al. (2001) How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 84:179–185

    Article  PubMed  Google Scholar 

  29. Söllner W, Maislinger S, Kappauf H (2003) How to improve communication between physicians and cancer patients about use of complementary and alternative medicine? Psycho Oncology 12:203–204

    Article  PubMed  Google Scholar 

  30. Suchman AL, Markakis K, Beckman HB, Frankel R (1997) A model of empathetic communication in the medical interview. JAMA 277:678–682

    Article  CAS  PubMed  Google Scholar 

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Correspondence to H. W. Kappauf.

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Gewidmet meinem onkologischen Lehrer Herrn Prof. Dr. Walter M. Gallmeier, dem Initiator der Kühlungsborner Kommunikationskurse

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Kappauf, H.W. Kommunikation in der Onkologie. Hautarzt 55, 709–714 (2004). https://doi.org/10.1007/s00105-004-0767-7

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