Communication Skills Training to Improve Confidence and Skills in Pediatric Cancer Truth-Telling of Registered Nurses: A Quasi-Experimental Study

Aims: Evaluate the effectiveness of combining an online pediatric communication skill training (PedCST) with an interactive e-picture book application by measuring outcomes for registered nurses (RNs), children with leukemia, and their parents. Methods: This quasi-experimental study implemented a PedCST designed for RNs followed by an interactive e-picture book application for children with leukemia and their parents. Outcome variables included RNs' communication confidence and skills; children's quality of life (QOL) and symptom distress; and parents' QOL, satisfaction with medical communication, and emotional distress. Multiple linear regression was used for data analysis. Results: Forty-three pediatric RNs and 29 pairs of children with leukemia and their parents were recruited. The PedCST effectively enhanced the RNs' confidence (p < 0.001, f = 0.68) and communication skills (p < 0.001, f = 0.26) when interacting with children with leukemia and their parents. The combined intervention showed a large effect on enhancing children's QOL (76.4 vs. 87.1, p < 0.01, f = 0.66) and relieving several distress symptoms (depression, anxiety, and appetite), but it had a limited impact on improving parents' QOL (54.1 vs. 48.0, p = 0.202), satisfaction with medical communication (4.4 vs. 4.5, p = 0.159), or emotional distress (3.3 vs. 2.6, p = 0.209). Conclusions: The PedCST enhanced RNs' confidence and communication skills. Additionally, the combined intervention effectively improved children's QOL and emotional well-being. However, its impact on parents' QOL, communication satisfaction, and emotional distress could not be confirmed with our quasi-experimental design. These findings demonstrated the potential effectiveness of the innovative intervention; however, further research with a control group is necessary to accurately confirm its effectiveness.