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Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers

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Abstract

Purpose

Patients often struggle to express their emotional concerns to their oncology providers and may therefore experience unmet needs. This paper describes the development and implementation of an online program that teaches patients how to communicate their emotions to their oncology providers.

Methods

The intervention was developed by a multidisciplinary team consisting of palliative care physicians, psychologists, and an intervention software developer and included input from patients. It incorporated elements of Social Cognitive Theory and validated cognitive behavioral strategies for communication skills training. Strategies to increase intervention adherence were implemented midway through the study.

Results

The intervention consists of four interactive, online modules to teach patients strategies for expressing emotional concerns to their providers and asking for support. In addition to skill-building, the intervention was designed to raise patients’ expectations that expressing emotional concerns to providers would be helpful, to enhance their self-efficacy for doing so, and to help them overcome barriers to having these conversations. After implementing strategies to improve adherence, usage rates increased from 47 to 64 %.

Conclusions

This intervention addresses an unmet educational need for patients with advanced cancer. Strategies to increase adherence led to improvements in usage rates in this population of older patients. We are currently evaluating the intervention in a randomized clinical trial to determine its efficacy in increasing patient expression of emotional concerns and requests for support. If successful, this intervention could serve as a model for future online patient education programs.

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Acknowledgments

Preparation of this manuscript was supported by grant R01 CA100387 from the National Cancer Institute.

Conflict of interest

The authors declare that there is no conflict of interest. In particular, there has not been any personal involvement of any of the authors with the funding agency. The authors have full control of the primary data and they agree to allow the journal to review their data if requested.

Author information

Authors and Affiliations

  1. Duke University, Durham, NC, USA

    Laura S. Porter, Kathryn I. Pollak, Meredith Cooper & James A. Tulsky

  2. People Designs, Inc., Durham, NC, USA

    David Farrell

  3. University of Pittsburgh, Pittsburgh, PA, USA

    Robert M. Arnold

  4. Health Services Research and Development Service, Durham VA Medical Center, Durham, NC, USA

    Amy S. Jeffreys & James A. Tulsky

Authors
  1. Laura S. Porter
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  2. Kathryn I. Pollak
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  3. David Farrell
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  4. Meredith Cooper
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  5. Robert M. Arnold
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  6. Amy S. Jeffreys
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  7. James A. Tulsky
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Corresponding author

Correspondence to Laura S. Porter.

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Porter, L.S., Pollak, K.I., Farrell, D. et al. Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers. Support Care Cancer 23, 2907–2916 (2015). https://doi.org/10.1007/s00520-015-2656-2

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  • DOI: https://doi.org/10.1007/s00520-015-2656-2

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