Full title: Communication Guidelines in Oncology: Communication skills of clinical staff and the process of providing information to people with cancer and their families
Authors: Working Group of the “Communication Guidelines in Oncology: Communication skills of clinical staff and the process of providing information to people with cancer and their families. Cross-Cutting and During-Care Aspects”
Contact: participacion.redets@sescs.es
Descripción
Methodological document developed within the Programme of Clinical Practice Guidelines and Other Evidence-Based Products of the National Health System. This document was produced by the SESCS, within the framework of funding from the Ministry of Health for the development of the activities included in the annual work plan of the Spanish Network of Health Technology Assessment Agencies and Services of the National Health System (RedETS).
ABSTRACT
Introduction
Effective communication between clinical staff and individuals with cancer is fundamental for optimizing healthcare delivery, enhancing treatment adherence, and strengthening the emotional
well-being of individuals with cancer. However, significant challenges persist, including insufficient training in communication skills, a lack of standardized materials, limited consultation time, and difficulties in addressing sensitive conversations. In this context, the development of evidence-based communication guidelines is essential to provide structured strategies aiming to improve
communicative interactions in clinical encounters.
Aims
To develop Oncology Communication Guidelines based on scientific evidences to enhance the communication between healthcare professionals and individuals with cancer and their family.
Methodology
The methodological framework was structured into three phases:
1. Systematic Review (SR) of the scientific literature to identify communication recommendations in oncology. A search was conducted in Medline (Ovid), EMBASE (Elsevier), and Cochrane library (Wiley), covering publications from January 2014 to August 2024, with no language restrictions. A total of 582 relevant studies were identified, from which 30 were selected following a rigorous evaluation of inclusion and exclusion criteria.
2. Two-round Delphi study, involving 36 experts (12 clinicians, 14 representatives from scientific societies, and 10 from patient associations). In the first round, 24 participants responded, and
in the second, 32 experts provided their input. The key recommendations were prioritized and agreed upon using a 5-point Likert scale, establishing a consensus criterion of 75% agreement
among participants. Consensus was considered achieved for recommendations that reached at least this percentage in either the highest levels of the scale (4 and 5) or the lowest levels
(1 and 2).
3. Development and validation of the Oncology Communication Guidelines, including an external review by healthcare professionals and delegates of associations of individuals with cancer and their family. The final version incorporates structured dialogues and various resources to facilitate its application in clinical practice.
Results
The Delphi study led to a consensus on 48 essential recommendations to improve communication between clinical staff and individuals with cancer. These recommendations include methods for
structuring conversations regarding diagnosis, prognosis, therapeutic options, and palliative care. Specific dialogues were designed to address different stages of the oncology process, facilitating
clinician-person with cancer interaction and integrating a person-centered approach.
Conclusions
The implementation of evidence-based Oncology Communication Guidelines can significantly enhance the quality of care and the experience of individuals with cancer. Effective communication enables individuals with cancer to better understand their illness, actively participate in decision-making, and receive the appropriate emotional support at each stage of care. Additionally, it facilitates the work of clinical staff by reducing the emotional burden and stress impact when communicating complex information. It is also recommended to integrate continuous training in communication skills and promote a person-centered model and shared decision-making as complementary strategies
