Effectiveness Not Established

Provider Communication Skill Training

for Depression

Provider communication skill training is an approach in which the healthcare professional who provides services to the patient is trained to improve communication skills. Improved communication with the patient is proposed to have a positive effect on the patient’s symptoms and outcomes. Improved provider communication skills may improve assessment of the patient and the provider’s ability to facilitate effective communication by the patient, thereby enhancing symptom management. The effect of communication skill training to providers in cancer care has been examined for its effect on patient anxiety and depression and on caregiver strain and burden.

Systematic Review/Meta-Analysis

Moore, P.M., Rivera Mercado, S., Grez Artigues, M., & Lawrie, T.A. (2013). Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database of Systematic Reviews, 2013(3). 

Purpose

STUDY PURPOSE: To assess the effects of communication skills training for healthcare professionals involved in cancer care
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, SIGLE, PsycINFO, dissertation abstracts, evidence-based medicine reviews
 
KEYWORDS: Detailed search documentation provided in article appendix
 
INCLUSION CRITERIA: Studies that involved communication skills training interventions of any type for all professionals and allied healthcare providers; randomized, controlled trials, or cluster-randomized studies
 
EXCLUSION CRITERIA: Not specified

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 5,472
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Evaluation of risk of bias according to the Cochrane Handbook

Sample Characteristics

FINAL NUMBER STUDIES INCLUDED = 15 studies with 10 studies in meta-analysis
 
TOTAL PATIENTS INCLUDED IN REVIEW = 1,147 professionals (2,105 patient encounters)
 
KEY SAMPLE CHARACTERISTICS: Only two studies examined effects on anxiety; one study examined effects on depression

Results

Two studies evaluated patient anxiety using the Spielberger State-Trait Anxiety Inventory. Anxiety declined in both study groups, but the reduction in anxiety was significantly greater in the control group (n = 169, SMD = .4, p = .02). Other results of training explored were sensitivity of communications, display of empathy, patient trust, quality of life, and patient recall of information, distress, and satisfaction. One study showed no impact on patient depression.

Conclusions

Provider communication skill training was not shown to have a positive effect on patients' level of anxiety or depression. Physician training was more likely to result in communications showing empathy.

Limitations

Type, duration, and timing of training interventions were very diverse, making the synthesis of findings difficult. Similarly, the timing of study follow-up assessments varied. For the individual outcomes examined, the number of available studies was small.

Nursing Implications

Communication skill training is likely to improve some communication skills of providers, but evidence regarding any impact of this on patient outcomes is lacking, and long-term effects are unknown. The most effective training method also is unclear. Given the current emphasis on shared decision-making and patient-centered care, the importance of provider communication and information-giving skills is evident. The content of training should be aimed at achieving these aspects and empowering patients. Further research is needed to determine the best approaches to achieve these goals.

Print