Communication Skills Of Health Professionals Research Articles

Characteristics and communication skills of health professionals in implementing provider-initiated HIV testing and counselling (PITC) for Indonesian pregnant women

Background: HIV testing for pregnant women is an important test during pregnancy. HIV testing for pregnant women is a way to prevent mother-to-child HIV transmission. Objectives: To investigate the relationship between the characteristics and communication skills of health professionals while conducting provider-initiated HIV testing and counselling (PITC) for pregnant women. Methods: This was an observational study with a cross-sectional approach. The study was conducted at 23 public health centres with 80 health professionals who conduct PITC. The data was analysed using the Chi-Square test. Results: There was a correlation between the characteristics and communication skills of respondents. Relationships were observed between respondents trained on PITC and communication with patients during PITC sessions (p=0.002); work experience and non-verbal communication skills (p=0.047), and type of profession of respondents and non-verbal communication skills (p=0.029). Conclusions: Communication skills had a relationship with experienced training on PITC, work experience, and type of profession. Increasing the communication skill of health professionals through work experience and training or education to improve the ability of health professionals in PITC services.

Qualitative evaluation of the life experiences of spouses of prostate cancer patients receiving androgen deprivation therapy.

This study was conducted to qualitatively evaluate the life experiences of women whose spouses had been receiving androgen deprivation therapy. The purposive sample of the research, in which a descriptive phenomenological design was used, consisted of 15 women. The data were evaluated according to Colaizzi's phenomenological analysis steps. The views of the participants were classified into 7 themes: loss and grief, physical difficulties, socioeconomic difficulties, psychological difficulties, relational changes, strengths, and benefits. It was determined that women whose husbands had been receiving ADT experienced grief responses and physical, socioeconomic, and psychological difficulties. Psychological difficulties were found to include care burden, hospital stress, sexuality, and burnout. It was observed that the patients and their spouses experienced some positive and negative relational changes. Satisfaction with health services and resilience were facilitating factors for female spouses to adapt to the treatment process. It was determined that during the adaptation to the disease and treatment process, the participants had some needs such as family support, economic support, reduction of negative representations in the media, and enhancement of communication skills of health professionals. Moreover, they were found to have some benefits related to post-traumatic growth. Uro-oncology nurses can develop services intended to improve the well-being of the wives of men receiving ADT and use the knowledge and experience of uro-oncology nursing for the benefit of both patients and caregivers.

Leaving a Legacy: Allied Health Professionals' Perceptions of Fertility Preservation and Posthumous Reproduction for Adolescent and Young Adults with a Poor Cancer Prognosis.

Purpose: To explore Allied Health Professionals' (AHPs) experiences with and perceptions of posthumous assisted reproduction (PAR) among adolescent and young adults (AYA, ages 15-39) with a poor cancer prognosis. Methods: We conducted a qualitative analysis of video-based 90-minute focus groups (FGs) of AHPs who participated in the Enriching Communication Skills for Health Professionals in Oncofertility (ECHO) training program from May to August 2021. Moderator-facilitated discussions were guided by topics related to experiences around discussions and utilization of PAR among AYA with a poor cancer prognosis. Thematic analysis was conducted using the constant comparison method. Results: Forty-three AHPs participated in one of seven FGs. Three themes emerged: (1) PAR as palliative care: preserving patient's legacy for their partner, siblings, and parents; (2) ethical and legal considerations for balancing patient's time-sensitive needs; and (3) barriers AHPs encounter navigating complex dynamics of care in this population. Subthemes included an emphasis on patient autonomy, a multidisciplinary approach to counseling, early initiation of fertility discussions continuing over time, documenting reproductive desires, and concerns for family and offspring after patient death. Conclusions: AHPs desired timely conversations on reproductive legacy and family planning. In the absence of institutional policies, training, and resources, AHPs emphasized feeling ill-equipped to navigate the complex dynamics between patients, families, and colleagues. The development of transparent institutional policies, implementation of multidisciplinary care teams, and oversight with ethics committees may improve the provision of reproductive health care and/or end-of-life care for AYA with a poor cancer prognosis and their families.

For the LOvE of Reproductive Health Communication: Assessment of the LGBT Oncofertility Education (LOvE) Module.

Purpose: The lesbian, gay, bisexual, transgender, and queer (LGBTQ) Oncofertility Education (LOvE) module aims to improve knowledge on providing inclusive and affirming care for LGBTQ adolescents and young adults (AYAs) with cancer. The objective of this study is to evaluate the role of the module in improving reproductive health communication for the care of LGBTQ AYAs with cancer. Methods: A 10-item multiple-choice pre-test and post-test assessed learner knowledge, with total knowledge scores ranging from 0 (no correct responses) to 10 (all correct responses). A post-module survey and open-ended questions assessed relevance of the module, quality, and appropriateness to professional practice. Paired t-tests analyzed changes in knowledge before and after the module. Content analysis was applied to qualitative responses. Results: Thirty-seven learners completed both the pre-test and post-test. Around 8.1% correctly answered all pre-test questions; 59.5% correctly answered all posttest questions. The average pre-test score was 8.3, versus posttest score of 9.5 (p < 0.0001). Eighty-nine percent of learners strongly agreed that LOvE Enriching Communication Skills for Health Professionals in Oncofertility was relevant to their work; 95% strongly agreed that it was easy to understand and navigate. Open-ended responses highlighted how the module helped learners strengthen the provider-patient relationship in the context of oncofertility, create a safe space for patients, and understand the relevance of educational materials about fertility to LGBTQ patients. Conclusions: We found significant improvement in knowledge of reproductive health care for LGBTQ AYAs with cancer after completing the module. Improving provider knowledge may improve confidence in providing inclusive and affirming care for LGBTQ AYAs with cancer, resulting in improved whole-person care.

Perspectives surrounding fertility preservation and posthumous reproduction for adolescent and young adults with terminal cancer: Survey of allied health professionals.

While all reproductive-aged individuals with cancer should be offered fertility preservation (FP) counseling, there is little guidance over offers to adolescent and young adults (AYA) with terminal diagnoses, especially when considering posthumous assisted reproduction (PAR). The Enriching Communication skills for Health professionals in Oncofertility (ECHO/ENRICH) trains Allied Health Professionals (AHPs) to improve communication with AYAs with cancer. Little is known about AHPs' role in assisting in FP and PAR decisions. This is a cross-sectional survey of ECHO/ENRICH trainees' attitudes and experience with FP and PAR in AYA with terminal cancer. The response rate was 61% (365/601). While 69% felt comfortable discussing FP with terminal AYA after ECHO/ENRICH training, 85% desired further education. The majority (88%) agreed FP should be an option for AYA with cancer, though some agreed offering FP provided false hope (16%) or was a waste of resources (7%). Most shared that avoidance of FP discussions was common practice, especially in the medically fragile, late-stage disease, or among minors. Many attributed lack of conversations to oncology team goals. Only 9% had prior experience with PAR. Many were conflicted about how PAR reproductive material should be gifted and who should be permitted to use PAR. Several raised moral concerns for PAR, or discomfort advising family. Many voiced desire for additional PAR-specific education. ECHO/ENRICH trainees had varied levels of exposure to FP in terminal AYA and limited experiences with PAR. Many expressed uncertainties with PAR, which may be alleviated with further training and transparent institutional policies.

A FORMAÇÃO DO PROFISSIONAL EM SAÚDE: VERTICALIDADE DOS SABERES E SEU O IMPACTO NO APOIO À AMAMENTAÇÃO

This study aims to reflect the current training model of health professionals, based on the biomedical model that reflects the authoritarian, unidisciplinary position and with intense use of the apparatus that profits from the disease. The vertical professional-patient relationship hinders the reception, counseling, and, consequently, the maintenance of breastfeeding. The methodology used was an integrative literature review of the last five years. It highlights the importance of improving the communication skills of health professionals, reformulating the current health training model and thus enabling the rise of breastfeeding rates in Brazil.

Health-Seeking Behaviors in Mozambique: A Mini-Study of Ethnonursing.

In settings where traditional medicine is a crucial part of the healthcare system, providing culturally competent healthcare services is vital to improving patient satisfaction and health outcomes. Therefore, this study sought to gain insight into how cultural beliefs influence health-seeking behaviors (HSBs) among Mozambicans. Participant observation and in-depth interviews (IDIs) were undertaken using the ethnonursing method to investigate beliefs and views that Mozambicans (living in Pemba City) often take into account to meet their health needs. Data were analyzed in accordance with Leininger’s ethnonursing guidelines. Twenty-seven IDIs were carried out with 12 informants from the Makonde and Makuwa tribes. The choice of health service was influenced by perceptions of health and illness through a spiritual lens, belief in supernatural forces, dissatisfaction with and dislike of the public medical system on grounds of having received poor-quality treatment, perceived poor communication skills of health professionals, and trust in the indigenous medical system. This study confirmed the need for health professionals to carefully take cultural influences into consideration when providing care for their patients. We recommend an educational intervention that emphasizes communication skills training for healthcare workers to ensure successful physician/nurse–patient relationships.

Evolution and growth of the ECHO (Enriching Communication skills for Health professionals in Oncofertility) program: a 5-year study in the training of oncofertility professionals.

PurposeAYAs with cancer have unique psychosocial needs, with reproductive health being a primary concern. The ECHO training program provides reproductive health communication training to individuals providing care for AYAs with cancer. The purpose of this project is to describe the growth of ECHO and evaluate changes in learner engagement over a 5-year period.MethodsECHO is an 8-week online training program offered annually, with the program including learning modules, discussion topics and reflections, and synchronous discussions. Reflection quality scores and number of words were compared between the 5 cohorts using ANOVA with a p < .05 level of significance. Descriptive statistics summarized module topics, reflections, and synchronous discussions.ResultsThe average number of reflections per unique learner increased each year (1.4 in cohort 1 vs 4.1 in cohort 5), as did average length and quality of reflections (72.1 words in cohort 1 vs 203.4 words in cohort 5, p < .0001; score of 1.21 in cohort 1 vs 4.46 in cohort 5, p < .0001). The percentage of learners in attendance at synchronous discussions increased between cohorts 4 and 5 (4.8% of learners in cohort 4 vs 18.8% of learners cohort 5).ConclusionsThe ECHO program has seen significant growth and improvement in learner engagement over a 5-year period. This is particularly important given that student learning outcomes in online courses can be predicted by the level of engagement with online content.Implications for Cancer SurvivorsAs fertility and reproductive health remain a top life goal and discussion priority for AYAs surviving cancer, increasing clinical competencies of AHPs in oncofertility is essential.

Better communication with migrant communities during COVID-19 pandemic:a portuguese experience

Abstract Odemira, in the southeast litoral of Portugal, has 33% of migrant citizens, mostly from Southeast Asia, going up to 50% counting transient citizens. Most of them do not speak English, making communication with health services difficult. They tend to live in overcrowded houses with unsanitary conditions. With the emergence of the COVID-19 pandemic, all the above resulted in high incidence and ineffective contact tracing (CT), testing and isolation by the public health teams. It was essential to develop strategies to manage and control outbreaks, and also to achieve health equity. Our experience can be useful for other countries in dealing with their multicultural communities. This intervention started in march 2020 and is still ongoing. The aims were to improve the accuracy of epidemiological surveys (ES) and CT, to more easily stop transmission, to develop the communication skills of health professionals and to improve migrant's healthcare access. For this, the focus was on digital written communication tools (Whatsapp, translation apps). It was created a toolkit to guide ES and CT tailored to the migrant population, with tips and best practices, and used translated information materials about preventive COVID-19 measures. Workshops were led with health professionals. It was stablished work with local NGOs, creating social media campaigns during crucial events (Holi holliday). As results. it was achieved a better ES output, more accurate CT and better transmission control, with noticeable differences between march 2020 and now. The relationship with this community improved, having better access to services and their needs met. Health professionals reported being more at ease dealing with these patients. Our experience shows it's possible to communicate effectively despite language and cultural barriers, that cultural knowledge is important in advancing public health goals and that multidisciplinary and intersectoral work is essential to effective interventions. Key messages This intervention allowed us to achieve a better output of epidemiological surveys, more accurate contact tracing and were more effective in breaking transmission chains and controlling outbreaks. It was achieved a better understanding and relationship with this community, with better ability to respond to their needs and promoting their access to healthcare.

English

BACKGROUND Communication plays a crucial role in the present era of medical litigations and hospital attacks. A good doctor has to be a good communicator. 80 % of medical errors are due to communication failure as reported in a study. The need for improving the medical communication skills of health professionals is getting recognized. The use of structured programme of effective and formal communication skills training is the need of the hour. In order to improve communication skills, Medical council of India (MCI) has launched the ATECOM (attitude, ethics and communication) module in the MBBS curriculum from 2019. The purpose of this study was to assess the attitude of medical students towards learning communication skills. METHODS A total of 447 students from 7 batches were enrolled in the study. All students were asked to fill up the communication skills attitude scale (CSAS) questionnaire which consists of 13 positive attitude questions and 13 negative attitude questions which was scored in Likert’s scale. The data was analysed using Statistical Package for Social Sciences (SPSS). RESULTS There were a total of 447 students, of which 128 were males and 319 were females. The mean total score for positive attitude was 54.19 (SD - 5.99) and the mean score for negative attitude was 33.42 (SD - 5.27). The mean positive attitude score was more for females (54.61; SD - 5.82) than males (53.15; SD - 6.28) and the difference was statistically significant. The female students had a lesser mean negative attitude score compared to males. Batch wise analysis was done using analysis of variance (ANOVA). The P value for total positive score between batches was 0.001 and for total negative score was 0.28. CONCLUSION The study showed an overall positive attitude to learning communication skills with girls showing a more positive attitude and less negative attitude than boys. KEY WORDS Attitude, Communication skills, Medical Students, Competency

ASSESSMENT OF A TRAINING MODULE ON REPRODUCTIVE HEALTH COMMUNICATION FOR SEXUAL AND GENDER MINORITY (SGM) ADOLESCENTS AND YOUNG ADULTS (AYAs) WITH CANCER

AYAs with cancer have unique psychosocial needs, with reproductive health being a primary concern. Additionally, health disparities exist among SGM AYAs and there is a gap in clinician training. The NCI-funded R25 Enriching Communication Skills for Health Professionals in Oncofertility (ECHO) provides reproductive health communication training to allied health professionals, including social workers, psychologists, nurses, and physicians assistants, who provide care for AYAs with cancer. The ECHO curriculum expanded to include the LGBT Oncofertility Education (LOvE) module.

A discourse analysis of health provider interactions with parents who are reluctant to vaccinate

ObjectiveVaccine hesitancy is a persistent barrier to vaccination uptake, and health professionals report interactions with such parents to be difficult. Using discourse analytic techniques, we examine the foundation of a therapeutic relationship: the display of empathy and attempts to build rapport, in consultations between immunisation specialists and vaccine reluctant parents. MethodsConsultations between consenting clinicians and parents in two Specialist Immunisation Clinics in Australia were recorded. Twelve conversations between the clinicians and parents were analysed using interactional sociolinguistic (IS) discourse analytic methods. ResultsThis paper takes a case study approach by citing two interactions that exemplify the interactional work of the consultants as they strive to engender mutual understanding and goodwill, noting examples of discursive choices that demonstrate empathy and the building of rapport. ConclusionAwareness of discourse strategies that interweave relational and clinical goals enable a more nuanced understanding of communication skills that support a guiding partnership in vaccine related decisions with parents. Practical implicationsThrough highlighting the strategic interactional work that displays empathy and builds rapport, we can inform educational approaches and build a repertoire of communication choices that strengthen the communication skills of health professionals.

Training in communication skills for self-efficacy of health professionals: a systematic review

BackgroundCommunication skills are essential for health professionals to establish a positive relationship with their patients, improving their health and quality of life. In this perspective, communication skills training can be effective strategies to improve the care provided by professionals in patient care and the quality of health services.ObjectiveTo identify the best available evidence on training programs in communication skills to promote changes in attitude and behavior or self-efficacy of health professionals.MethodsSystematic searches were performed in eight databases, evaluating Randomized Controlled Trials and quasi-experimental studies with a control group, focusing on training communication skills for health professionals, who assessed self-efficacy or behaviors related to these skills. The phases of study selection and data extraction were carried out by two independent researchers, and the conflicts were resolved by a third. The risk of bias was assessed using the Cochrane method.ResultsEight studies were included in the review. Most programs lasted between 4½ h and 2 days, involved information about communication skills and the content was applied to the health professionals’ context. Several teaching strategies were used, such as lectures, videos and dramatizations and the evaluation was carried out using different instruments. Improvements in the performance and in the self-efficacy of communication skills were observed in the trained groups. The RCT had a low risk of bias and the quasi-experimental studies had a moderate risk.ConclusionTraining in communication skills can improve the performance and self-efficacy of health professionals. Programs that approach the conceptual issues and promote the space for experiential learning could be effective in communication skills training for professionals.PROSPERO: CRD42019129384

Understanding the complexities of unexplained stillbirth in sub-Saharan Africa: a mixed-methods study.

ObjectiveTo understand the complexities surrounding unexplained stillbirth for the development and implementation of culturally acceptable interventions to underpin care in Tanzania and Zambia.DesignMixed‐methods study.SettingTertiary, secondary and primary care facilities in Mansa, Zambia, and Mwanza, Tanzania.SampleQuantitative: 1997 women giving birth at two tertiary care facilities (one in each country). Qualitative: 48 women and 19 partners from tertiary, secondary and primary care facilities.MethodsCase review using data from a target of 2000 consecutive case records. Qualitative interviews with a purposive sample of women and partners, using a grounded theory approach.ResultsA total of 261 stillbirths were recorded, with a rate of 16% in Tanzania and 10% in Zambia, which is higher than the previous estimates of 2.24 and 2.09%, respectively, for those countries. Women in both countries who reported a previous stillbirth were more likely to have stillbirth (RR 1.86, 95% CI 1.23–2.81). The cause of death was unexplained in 28% of cases. Qualitative findings indicated that not knowing what caused the baby to be stillborn prevented women from grieving. This was compounded by the poor communication skills of health professionals, who displayed little empathy and skill when counselling bereaved families.ConclusionsThe stillbirth risk in both facilities was far higher than the risk recorded from national data, with women reporting a previous stillbirth being at higher risk. Women want to know the cause of stillbirth and an exploration of appropriate investigations in this setting is required. Providing health professionals with support and continuing training is key to improving the experiences of women and future care.Tweetable abstractStillbirths receive little investigation and are often unexplained. Communication with women about the death of their baby is limited.

Abstract PO-014: Assessment of training needs for clinicians who provide reproductive health counseling for sexual and gender minority adolescents and young adults with cancer

Abstract Background: Adolescent and young adults (AYA) with cancer have distinct psychosocial needs, with reproductive health being a chief concern. Reproductive health includes fertility, contraception, romantic relationships, body image, sexuality and disease prevention. Along with the unique needs of AYAs with cancer, health disparities exist among sexual and gender minority (SGM) AYAs, and there is a gap in clinician training. Our NCI-funded R25 Enriching Communication skills for Health professionals in Oncofertility (ECHO) provides reproductive health communication training to psychologists, social workers, nurses, and physician assistants who provide care for AYA people diagnosed with cancer. To refine our curriculum to address the unique needs of SGM AYAs with cancer, we conducted a survey of prior ECHO trainees to evaluate knowledge and comfort in obtaining sexual orientation and gender identity (SOGI) information from patients and providing reproductive health counseling. Methods: A 28-item electronic survey was distributed to 601 prior ECHO trainees. Quantitative items assessed: SOGI data collection at their institution; SGM AYA cancer-related health knowledge; adequacy of ECHO training for SGM AYAs; desire for additional training; comfort discussing reproductive health with SGMs; and confidence in knowledge of SGM health needs (pre- and post-survey). Response options ranged from 1=strongly agree to 5=strongly disagree, or ‘prefer not to answer. Total knowledge score was computed and ranged from 0=no correct responses to 7=all correct. Self-perceived comfort and confidence were assessed with regard to specific patient subgroups (i.e., gay/lesbian; bisexual/queer; and trans/nonbinary patients). Four open-ended items invited respondents to describe personal experiences, reservations, and suggestions for improving SGM AYA cancer care. Quantitative responses were summarized with descriptive statistics. Paired t- tests were used to analyze changes in confidence. Content analysis was applied to qualitative responses. Results: Of the 346 who completed the survey (58% response rate), only 7.4% correctly answered all knowledge questions (M=3.76, SD=1.72). One- third thought ECHO training adequately addresses SGM needs, and the majority (89%) wanted additional training in SGM reproductive health. Confidence in knowledge of SGM health was neutral in all subgroups prior to survey completion (M=3.05, SD=1.02), but reduced significantly for bisexual/queer (M=-0.21 t(307)=4.70, p&amp;lt;.001) and transgender/nonbinary health(M=-0.12 t(307)=2.66, p=.008). Open-ended responses focused on experiences caring for SGM AYAs with cancer; training needs; and appreciation for the survey. Conclusions: Our findings demonstrate a need to expand our ECHO curriculum to include SGM reproductive health concerns and strong desire for SGM content among trainees. We are developing a module to improve reproductive health communication for the care of SGM AYAs with cancer and survivors. Citation Format: Rhyan J. Toldeo, Amani Sampson, Paige W. Lake, Megan E. Sutter, Ash B. Alpert, Matthew B. Schabath, Susan T. Vadaparampil, Gwendolyn P. Quinn. Assessment of training needs for clinicians who provide reproductive health counseling for sexual and gender minority adolescents and young adults with cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-014.

Cross-cultural Adaptation, Reliability, and Validity of the Turkish Version of the Health Professionals Communication Skills Scale

The aim of this study is to evaluate the psychometric properties of the Turkish version of the Health Professionals Communication Skills Scale (HP-CSS). The HP-CSS was translated into Turkish following an international instrument translation guideline. A convenience sample of 394 health professionals participated in this study. Internal consistency reliability, content validity, test-retest reliability, and convergent validity were assessed. A confirmatory factor analysis was conducted to evaluate the construct validity. The Turkish version of HP-CSS comprised four factors (empathy, informative communication, respect, and social skill). The HP-CSS-TR demonstrated adequate internal consistency (Cronbach'sα values .72-.79). In terms of the content validity, the scale-level content validity index (CVI) was .94, and the item-level CVI ranged from .83 to 1.00. The HP-CSS-TR showed good test-retest reliability (intraclass correlation coefficients were above .82). No statistically significant difference was found between the applications. There was a good agreement between the HP-CSS-TR and communication skills inventory (CSI) scales. Confirmatory factor analysis results (χ2/df, GFI, AGFI, IFI, TLI, CFI, RMSEA, and SRMR) showed a good fit for the original four-factor model. Results showed that the Turkish version of the HP-CSS is a valid and reliable tool for the assessment of communication skills of health professionals in Turkey. The use of the HP-CSS-TR measure in clinical settings could be useful in enhancing the quality of care by identifying inadequacies and improving communication skills.

CLINICIAN TRAINING NEEDS IN REPRODUCTIVE HEALTH COUNSELING FOR SEXUAL AND GENDER MINORITY AYA WITH CANCER

Adolescent and young adults (AYA) with cancer have distinct psychosocial needs, with reproductive health being a chief concern. Reproductive health includes fertility, contraception, romantic relationships, body image, sexuality and disease prevention. Along with the unique needs of AYAs with cancer, health disparities exist among sexual and gender minority (SGM) AYAs, and there is a gap in clinician training. Our NCI-funded R25 Enriching Communication skills for Health professionals in Oncofertility (ECHO) provides reproductive health communication training to psychologists, social workers, nurses, and physician assistants who provide care for AYA people diagnosed with cancer.

Percepção de pacientes sobre sua relação com médicos

Resumo A comunicação adequada é fundamental para a relação médico-paciente e para melhorar a qualidade dos atendimentos. Diante disso, o objetivo deste estudo foi conhecer a percepção de 200 pacientes na cidade de Aracaju/SE sobre sua relação com os médicos. Trata-se de estudo exploratório, transversal, descritivo e quantitativo, com aplicação de questionário. A amostra foi composta majoritariamente por adultos jovens, do sexo feminino (71,5%), solteiros (50%), sem nível superior (47,5%), atendidos principalmente em hospitais da rede pública (26,5%). Um ambiente favorável para a boa relação médico-paciente depende não apenas da infraestrutura clínico-hospitalar, mas também da habilidade comunicativa dos profissionais. Quanto à relação com os médicos, a maioria relatou estar satisfeita (86%) e confiar nos profissionais (84%). A privacidade do paciente também foi respeitada na maioria dos casos.

Initiating the Conversation of Oncofertility: The Creation of a Dedicated BMT Oncofertility Nurse Coordinator in the Transplant and Cellular Therapy Patient Population

Topic Significance & Study Purpose/Background/Rationale Patients undergoing hematopoietic stem cell transplantation face a high risk of infertility. Despite existing ASCO, ASRM and NCCN fertility preservation guidelines, as many as 68% of oncology patients report that fertility was not discussed prior to or during therapy. Since infertility in survivorship is known to increase distress and contribute to decreased quality of life, upfront oncofertility discussions must be more embedded into our programmatic education. To increase the prevalence and depth of fertility preservation counseling among Blood and Marrow Transplant (BMT) and cellular therapy patients, the BMT oncofertility coordinator role was developed. Methods, Intervention, & Analysis Two BMT advance practice providers and one transplant coordinator completed the ECHO (Enriching Communication Skills for Health Professionals in Oncofertility) training program through the Moffitt Cancer Center to deepen knowledge of oncofertility in our patient population. Through multidisciplinary working groups with institutional fertility specialists, the BMT team developed an algorithm and standardized workflow. A BMT oncofertility coordinator role was developed to ensure each BMT patient of reproductive age receives individual reproductive counseling, options to preserve, a same day referral to reproductive endocrinology, and support through complex coordination of care and financial support services once a fertility treatment option has been determined. If fertility preservation is not possible, the coordinator provides the information and counseling that increase patients' quality of life before, during and after cancer treatment. Findings & Interpretation Between September 2018 and September 2019, in the first year of this service the oncofertility coordinator has consulted with 102 patients of reproductive age. This role has assisted in addressing critical timeframes ensuring prompt referral to fertility preservation, access to fertility resources, as well as ensuring documentation of fertility preservation discussions in the medical record. Discussion & Implications The role of the BMT oncofertility coordinator has increased access to supportive oncofertility care at the time of cancer diagnosis for both BMT patients and patients across the health system as other clinics have begun consulting the BMT oncofertility coordinator. Increased awareness of the oncofertility services available is needed to ensure all patients of reproductive age are aware of their options for fertility preservation and are given the opportunity to have the family they may desire.

Training programs in communication skills to improve self-efficacy for health personnel: Protocol for a systematic review and meta-analysis.

Background:Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel.Methods:This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible.Results:This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy.Discussion:This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care.Dissemination and ethics:The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data.Systematic review registration:PROSPERO CRD42019129384.