Clinical Communication, Cancer Patients &Considerations to Minimize the Challenges

Clinical communication is a multidimensional concept, which encompasses the core of effective clinical practice. Communication in cancer patients is particularly challenging and yet a less focused area in cancer care. Various barriers and challenges in communication may affect the management protocol of cancer patients. Challenges may arise in various dimensions of cancer care including breaking bad news to delivery of complex clinical information, determination of appropriate treatment strategies, dealing with uncertainties, end of life counseling as well as cultural and language barriers affecting the whole communication dynamics. Effective communication is the basic foundation for responsive treatment decisions, positive health outcome, patient driven compliance and overall high quality of care. Thus, there is a need for acknowledging and actively deciphering the challenges and developing and promoting various protocols of effective communication skills in cancer patients.

Internet access, usage and trust among medical professionals in China:A web-based survey

Objectives:Social media has changed methods of communication in the medical profession.As part of a"doctor as communicator"strategy,Chinese medical professionals are actively embracing social media,which may have an impact on tense physician-patient relationships in China.This paper aims to examine a pattern of Internet access,Internet usage,and trust among Chinese medical professionals and further explores the reasons for these relationships on an individual level.Designs:A web-based questionnaire was designed,based on a media literacy model,and was divided into 3 dimensions:public information,general medical information,and specialty information.After a two-round pilot study,1001 physicians were included.Additionally,4 interviewees were chosen to participate in in-depth interviews and content analysis was performed.Data were analyzed using SPSS 25.0.Results:Findings showed that new media has become a major approach for medical professionals in China to retrieve and get access to various information.However,they still trust traditional media(n=1001,P<0.01)and professional journals more(n=1001,P<0.01).Internet access,usage,and trust were positively correlated(r-0.185-0.344,P<0.01).Regarding usage habits,47.66%of the participating physicians would practice science popularization through their new media accounts and 71.23%would forward approved health information within their professional realm.A validated instrument can be provided for further related studies.Conclusions:Science popularization is a specific usage of new media among Chinese medical professionals,through which they have achieved new authority and empowered communication because of self-media.To some extent,physician-patient relationships in China can be improved because this online interaction is conducive to building harmonious and lasting offline physician-patient relationships.

Tell health stories comprehensively and accurately: A case study of health edition of People's Daily

Objectives:People increasingly search for health information through the media and make decisions about their health based on these health stories.The mainstream media,including newspapers,are often the first source for the public to obtain health information.This study aims to assess the health stories reported in the health edition of People's Daily in 2019 with four tools of the Media Doctor Toolkit(MDT),which can be an effective tool to evaluate the quality of public health stories.Based on the results,we attempt to address the gap in media coverage in terms of reporting on public health issues,and promote media to display the image of medical staff objectively,both of which can improve relationship of doctors,nurses and patients.Methods:A prospective quantitative analysis of the quality of health stories reported in the health edition of People's Daily from 1 February to September 31,2019 was conducted.Forty-eight articles were collected and divided into four groups according to the MDT standards.Four rating tools were adapted from the MDT to assess the quality of the groups with corresponding criteria.Results:Forty-eight unique health stories were assessed with four MDT rating tools.The mean total satisfactory score was 80%.Health advice had the highest average satisfactory score,84%,compared with health policy group and public health problems and their solutions,at 80%and 77%,respectively.Health news group had the lowest score at 73%.Conclusion:This study provides a description of the quality of health stories on People's Daily.The overall quality of People's Daily was fairly good,although there was a wide range of quality between groups.The health edition of People's Daily covers a wide range of health topics such as new medical methods,doctorpatient relationship,advanced nursing practice,lifestyle change of health promotion etc.which promote excellence in providing the latest health information,representing medical staff image,resolve the disharmonious factors in the relationship between doctors and patients,and creating a good medical environment for the public.The findings of this study also provide insight into problems in health reporting of People's Daily.

Delivering bad news to patients——the necessary evil

Delivering bad news regarding patient's health is an unavoidable task for physicians and medical students in their careers.This is especially difficult for beginners.Disclosing undesired medical information to patients is technically and mentally demanding.Only with proper communication skills and sufficient patient-contact practice can medical practitioners smoothly cope with this stressful mission.There are a number of common mistakes we fall into when delivering bad news,which might induce or exacerbate patients' anxiety.Sometimes we are prone to disclose medical information in a "straight-to-the-point" manner.This is often a futile attempt made on the physician's part to ease his or her own uncomfortableness when delivering bad news,but unfortunately it does no good to facilitate patients' acceptance of the actual condition.Instead of using medical jargons,physicians are obliged to use "layman's terms" that make better sense to their patients.Declaring a clinical diagnosis without corresponding explanation on the prognosis and the discussion of treatment can also bring much confusion and anxiety to patients.Another even worse situation might be that we finish the "lecture" in our own words without confirming the patient's comprehension and addressing their questions.Professionals have recommended a six-step protocol on delivering bad news to patients:"SPIKES":S-Setting up the interview;P-assessing the patient's Perception;I-obtaining the patient's Invitation;K-giving Knowledge and information to the patient;E-addressing the patient's Emotions with Empathic responses;S-Strategy and Summary.

The difficulty of medical decision-making:should patients be involved?

Introduction The success or failure of treatment has long been attributed to the doctors alone,but the role of patients in the medical decision-making(MDM)process has often been ignored.As medical development and health needs increase,the desire of patients to participate in MDM continues to grow.This raises the question:should patients be involved in such a highly professional medical activity?How can their involvement bring better clinical benefits?

Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors： A Randomized Controlled Trial

Background： Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up. Methods： A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up （WFU） group or telephone follow-up （TFU） group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method. Results： Time consumption in WFU group for each patient （23.36 ± 6.16 min） was significantly shorter than that in TFU group （42.89 ± 7.15 min） （P 〈 0.001 ）; total economic cost in WFU group （RMB 90 Yuan） was much lower than that in TFU group （RMB 196 Yuan）. Lost-to-follow-up rate in the WFU group was 7.02% （4/57） compared with TFU group, 9.80% （5/51 ）, while no significance was observed （95% confidence interval [CI]： 0.176-2.740; P = 0.732）. The overall satisfaction rate in WFU group was 94.34% （50/53） compared with 80.43% （37/46） in TFU group （95% CI： 0.057-0.067; P = 0.034）. Conclusions： The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions.