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The association between the strength of the working alliance and sharing concerns by advanced cancer patients: a pilot study

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Abstract

Objectives

A strong therapeutic alliance between cancer patients and medical staff is associated with treatment adherence, better health outcomes, and an emotional acceptance of a terminal illness. Given its significant role, the current study investigated the association between the working alliance and sharing concerns by advanced cancer patients.

Methods

Advanced cancer patients completed the Working Alliance Inventory-Short Revised and a checklist of topics in which they rated their degree of concern about the topics and the degree of sharing them with their physician/nurse.

Results

Fifty-two patients completed the study. The working alliance was found to be strong with respect to treating physicians and nurses. The four topics that concerned patients the most were family coping with their illness (81 %), fear of future suffering (71 %), symptom control (67 %), and the oncological treatment (65 %). Patients with a strong working alliance with their physician shared to a higher extent the personal and main concern regarding their family’s coping, and a significant correlation was found between them (r = 0.53, p < .01). In addition, sharing fears of future suffering was also correlated with a strong working alliance with the physician (r = 0.28, p < .05). A strong working alliance with the nurse was correlated with discussing symptoms control (r = 0.30, p < .05).

Conclusion

These findings provide preliminary support for an association between the strength of the working alliance and the type of concerns that advanced cancer patients choose to discuss with their medical staff and highlight the importance of follow-up studies to further explore this association.

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Acknowledgments

The authors wish to thank Tania Mashiach for her help with the statistical analyses.

Conflict of interest

No author has any conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Gil Bar-Sela & Sivan Yochpaz

  2. Division of Oncology, Rambam Health Care Campus, POB 9602, Haifa, 31096, Israel

    Gil Bar-Sela, Doron Lulav-Grinwald & Inbal Mitnik

  3. Department of Psychology, University of Haifa, Haifa, Israel

    Rachel Gruber & Dan Koren

  4. Division of Psychiatry, Rambam Health Care Campus, Haifa, Israel

    Dan Koren

Authors
  1. Gil Bar-Sela
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  2. Sivan Yochpaz
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  3. Rachel Gruber
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  4. Doron Lulav-Grinwald
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  5. Inbal Mitnik
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  6. Dan Koren
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Correspondence to Gil Bar-Sela.

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Bar-Sela, G., Yochpaz, S., Gruber, R. et al. The association between the strength of the working alliance and sharing concerns by advanced cancer patients: a pilot study. Support Care Cancer 24, 319–325 (2016). https://doi.org/10.1007/s00520-015-2794-6

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  • DOI: https://doi.org/10.1007/s00520-015-2794-6

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