'Bad news consultations' with oncology nurses: Impact on perceived stress and patient experience. (February 2022)

• Record Type: Journal Article
• Authors: Guerdoux, Estelle; Trouillet, Raphaël; de Forges, Hélène; Valy, Laure; Jouvet, François; Chauvet, Christine; Champoiral, Patrice
• Is Part Of: European journal of oncology nursing. Volume 56(2022)
• Publication Date: 2022-02
• Subjects: Anxiety -- Bad news -- Cancer -- Consultations -- Nurses -- Patient-centered communication perceived stress -- Resilience; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2021.102085
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: 'Bad News Consultations' (BNC), conducted by nurses who are specialists in cancer, have been institutionally implemented in all French anti-cancer centres, to support the patient facing announcement-related stress. This study aimed to 1/describe the impact of the BNC on the patient's perceived stress and 2/determine the patient's benefits from the BNC. Method: This monocentric study, cross-sectional evaluation, used a mixed method, both quantitative and qualitative. During 8 months, 336 eligible participants who underwent a BNC were recruited by nurses. Perceived stress was self-assessed with a validated Visual Analogic Scale (VAS), at the beginning and at the end of the BNC. Stress resilience was self-assessed once using the CD-RISC2. Qualitative experiences were explored after the BNC, using a 25-item questionnaire. Multivariate analyses were conducted on perceived stress measures (on the VAS) to test mixed-effects models, including initial predispositions ( e.g., stress resilience) and organisational constraints ( e.g, interval between the medical consultation and the BNC). Results: Analyses on the perceived stress measures revealed a significant and negative effect of Time (B = −1.91; p < .001), Gender (B = 0.72; p = .03), and Resilience score (B = −0.43; p < .001), without any significant effect of the other incorporated random effects ( i.e., Type of cancer/treatment ) nor fixed effects ( i.e., Age, Organisational constraints ). Patients mostly reported having received necessary information, having their addressed emotions with empathetic responses and respect, perceived benefits in the healthcare pathway, and heard of some supportive cares. Conclusion: Perceived stress was reduced after BNCs. According to the patients, the BNCs allowed a better patient-centered communication and a better care pathway. Highlights: Perceived stress decreased after a bad news consultation (BNC) with a nurse. Perceived stress decreased thanks to beneficial patient-centered communication. BNCs allowed giving the patients necessary information on disease and care pathway. BNCs are places of active listening, expression and questions for the patients. Implementation of BNCs is justified to improve quality of oncologic care.