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Informing, communicating and sharing decisions with people who have cancer
  1. A J Sowden, associate director 1,
  2. C Forbes, research fellow 1,
  3. V Entwistle, programme director 3,
  4. I Watt, professor of primary care 2
  1. 1NHS Centre for Reviews & Dissemination, University of York, York YO10 5DD, UK
  2. 2Department of Health Studies, University of York
  3. 3Health Services Research Unit, University of Aberdeen, Aberdeen AB25 2ZD, UK
  1. Dr A J Sowden ajs18{at}

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There is widespread agreement that people should be informed about health care options and involved in decisions about their own care. In England and Wales the National Institute for Clinical Excellence (NICE) is intent on achieving a patient focus in its work and The NHS plan emphasises the need for patients to have more say in their own care and more influence over the way in which the NHS works.1 Similarly, The NHS cancer plan for England and Wales emphasises the need for good communication between health professionals and patients, both for delivering high quality care and for empowering people to be involved in decisions about their own care.2

This paper summarises Effective Health Care bulletin 6(6) which focused on communication, information giving, and sharing of decisions between health professionals and people with cancer. Evidence from systematic reviews produced by the Cochrane Consumers and Communication Group, other good quality systematic reviews, and from guidance produced by the National Cancer Guidance Steering Group is also included.

Communicating with patients

The most common complaints made by patients with cancer are about poor communication and inadequate information.34 In 1993 the General Medical Council (GMC) recognised the need to teach communication skills as part of the British undergraduate medical education. However, in a survey of all consultant non-surgical oncologists working in the UK to which 83% of the 476 consultants responded, almost half considered that they had not received sufficient training in communication skills.5

Communication skills programmes vary in their content and training methods. A recent systematic review evaluated communication training programmes for nurses.6 Of the 14 studies included, eight were based in an oncology setting (two randomised controlled trials, one controlled trial, and five pre/post tests). Only one study measured the effects on patients; this randomised controlled trial found reduced …

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