Communicating with Emotional Patients: Thoughts, Skills and Influencing Factors for Ontario Radiation Therapists

Abstract

Patients receiving radiation therapy are subject to very high anxiety levels. Therapists are uniquely positioned to support patients as they progress through treatment, but little is known about therapists’ ability to perform this important task. Therefore, this research was designed to describe radiation therapists’ ability to communicate with cancer patients during emotional interactions and to determine what intrinsic and extrinsic factors influence that ability. A two-phase consecutive mixed methods design was used. Single centre focus groups were used to develop themes for a questionnaire. That questionnaire was then distributed throughout 13 Ontario cancer centres. Themes evaluated included intrinsic factors (demographics, value, support education etc) and extrinsic factors (work environment and resources etc). A validated clinical vignette evaluated actual respondent communication ability. Inferential statistics were used to identify factors that influenced a respondent’s ability to correctly answer the vignette, and their overall satisfaction with provision of support to emotional patients. 199 responses were received from 13 large and small cancer centres, distributed broadly across Ontario. Response rate was low (31%) but wave analysis indicated a lack of non-response bias. Therapists showed a high degree of ability to effectively engage with emotional patients, with minimal use of blocking or controlling behaviors. 84% became radiation therapists to provide care and emotional support, and felt that this should be the focus of the profession. 63% of respondents felt satisfied with the quality of support they provide for emotional patients. Factors shown to significantly influence ability to communicate with emotional patients include personal sociability and experience, organizational provision of time, private space and support (p<0.05). This study demonstrates that radiation therapists are effective at communicating with emotional patients. That ability is significantly influenced by both personal and organizational factors. Most importantly these are experience and time. These findings are congruent with the literature for other professions and are likely generalisable throughout Canada and similar international practice environments.