Development and Testing of Cancer Truth-Telling Educational Model of Medical and Nursing Collaboration

Past studies showed that, there is a significant gap between doctors’ truth-telling approach and preference of patients with cancer and their family members. Medical and nursing collaboration should be beneficial to the improvement of quality of truth-telling and doctor-patient shared decision making (SDM). The main purpose of this study is to develop and test the effectiveness of cancer truth-telling educational model of medical and nursing collaboration. This educational model will focus on how to implement truth-telling well within limited time and how medical and nursing personnel could overcome difficulties when faced with family members’ request for truth concealment. The author integrated qualitative and quantitative methodologies to achieve the research purpose. Year 1 of this 3-year project mainly will investigate medical and nursing leaders’ ideas and suggestions on the development of truth-telling educational model of medical and nursing collaboration. The author will enroll the subjects through cancer-related associations, and the subjects will be 20 supervisors. This study will use purposive sampling and in-depth interview to collect data. Data collection and content analysis will be performed concurrently. The purpose of Year 2 is to amend teaching program, retrain facilitators, and simulate patients according the research results of Year 1. This study will use experimental design with stratified random assignment to allocate subjects to the experimental group (receive 6 hours CST) and the control group (without CST) to examine the short-term effectiveness (subjective data: confidence with truth-telling & satisfaction with CST and SDM; objective data: change on skills of cancer truth-telling & patient centered communication by using Roter interaction analysis system) of participation in communication skill training (CST) of 80 medical and nursing personnel. This study will use independent t-test to analyze data. The purpose of Year3 is to test the long-term effectiveness (3 & 6 months after the CST) of CST. This study will use experimental design and subjective (questionnaires) and objective methods (patients’ compliance with treatment and events of medical dispute) to evaluate medical and nursing personnel participating in the study and 300 patients with cancer receiving their services at hospital. This study will evaluate the long-term effectiveness through both medical and nursing personnel (confidence with truth-telling & satisfaction with truth-telling and SDM) and patients (satisfaction with truth-telling & SDM, emotional distress, and quality of life). Under the situation where intervening variables are controlled, GEE will be used to analyze the between-group difference. The study team will be composed of the experts in medicine, nursing, computer science & information engineering and statistics, and the findings will have positive contributions to education on truth-telling and further improve SDM.

Project ID:PF10701-0942
External Project ID:MOST106-2511-S182-005-MY2