nach oben

Supportive Care in Cancer

Erschienen in:

01.03.2007 | Original Article

Psychodynamic aspects of communication skills training: a pilot study

verfasst von: Nathalie Favre, Jean-Nicolas Despland, Yves de Roten, Martin Drapeau, Mathieu Bernard, Friedrich Stiefel

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2007

Einloggen, um Zugang zu erhalten

Abstract

Goals of work:

Communication between patients and oncology clinicians is a key element of cancer care. Emotionally charged consultations may trigger clinicians’ defense mechanisms, protecting them from painful emotions. Defense mechanisms, however, may also hamper the recognition of patients’ suffering. This pilot study aims to explore clinicians’ defense mechanisms observed in communication skills training (CST).

Patients and methods:

A verbatim transcription of videotaped interviews with simulated patients were evaluated before (N = 10) and after CST (N = 10) with the defense mechanism rating scales (DMRS).

Main results:

A wide variety of defense mechanisms were observed such as obsessional (e.g. intellectualisation) or disavowal (e.g. denial or projection). Immature defense mechanisms decreased after CST.

Conclusions:

A wide variety of defense mechanisms are operant in oncology clinicians facing challenging interviews with simulated patients. Defense mechanisms may be modified by CST.

Ablon JS, Jones EE (1998) How expert clinicians’ prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioral therapy. Psychother Res 8:71–83CrossRef

Baile WF, Kudelka AP, Beale EA, Glober GA, Myers EG, Greisinger AJ, Bast RC, Goldstein, MG, Novack D, Lenzi R (1999) Communication skills training in oncology: description and preliminary outcomes of workshops on breaking bad news and managing patient reactions to illness. Cancer 86:887–897PubMedCrossRef

Baile WF, Beale EA (2001) Giving bad news to cancer patients: Matching process and content. J Clin Oncol 19:2575–2577PubMed

Despland JN, Drapeau M, de Roten Y (2001) Les mécanismes de défense: une pluralité de points de vue. Psychothérapies 3:113–121

Despland JN, Stiefel F, Favre N, Drapeau M, de Roten Y (2005) Adaptation of the defense mechanism rating scales for evaluating therapists’ defense mechanisms: principles, reliability and face validity. Society for Psychotherapy Research, European and UK Chapters, Lausanne, 3 Mar 2005

Drapeau M, De Roten Y, Perry JC, Despland JN (2003) A study of stability and change in defense mechanisms during a brief psychodynamic investigation. J Nerv Ment Dis 191:496–502PubMedCrossRef

Fallowfield L (1995) Can we improve the professional and personal fulfillment of doctors in cancer medicine? Br J Cancer 71:1132–1133PubMed

Fallowfield L, Lipkin M, Hall A (1998) Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol 16:1961–1968PubMed

Fallowfield L, Jenkins V (1999) Effective communication skills are the key to good cancer care. Eur J Cancer 35:1592–1597PubMedCrossRef

10.

Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R (2002) Efficacy of a cancer research UK communication skills training model for oncologists: a randomised controlled trial. The Lancet 359:650–656CrossRef

11.

Fallowfield L, Jenkins V (2004) Communicating sad, bad and difficult news in medicine. The Lancet 363:312–319CrossRef

12.

Florio GA, Donnelly JP, Zevon MA (1998) The structure of work-related stress and coping among oncology nurses in high-stress medical settings: a transactional analysis. J Occup Health Psychol 3:227–242PubMedCrossRef

13.

Ford S, Fallowfield L, Lewis S (1996) Doctor–patient interactions in oncology. Soc Sci Med 42:1511–1519PubMedCrossRef

14.

Guex P, Stiefel F, Rousselle I (2002) La communication: Un élément central en cancérologie. Revue Francophone de Psycho-Oncologie 1:43–46

15.

Guldberg CA, Hoglend P, Perry JC (1993) Scientific methods for assessing psychological defences. Nordic Journal of Psychiatry 47:435–446 Taylor & Francis, United Kingdom (peer reviewed journal)

16.

Kiss A (1999) Communication skills training in oncology: a position paper. Ann Oncol 10:899–901PubMedCrossRef

17.

Lerman C, Daly M, Walsh WP, Resch N, Seay J, Barsevick A, Birenbaum L, Heggan T, Martin G (1993) Communication between patients with breast cancer and health care providers: determinants and implications. Cancer 72:2612–2620PubMedCrossRef

18.

Levinson W, Roter D (1993) The effects of two continuing medical education programs on communication skills of practicing primary care physicians. J Gen Intern Med 8:318–324PubMed

19.

Loge JH, Kaasa S, Hytten K (1997) Disclosing the cancer diagnosis: the patients’ experiences. Eur J Cancer 33:878–882PubMedCrossRef

20.

Meier DE, Back AL, Morrison RS (2001) The inner life of physicians and care of the seriously ill. JAMA 286:3007–3014PubMedCrossRef

21.

OPD Arbeitskreis (Hrsg) (1996) Operationalisierte Psychodynamische Diagnostik. Grundlagen und Manual. Verlag Hans Huber, Bern

22.

Parle M, Maguire P, Heaven C (1997) The development of a training model to improve health professionals’ skills, self-efficacy and outcome expectancies when communicating with cancer patients. Soc Sci Med 44:231–240PubMedCrossRef

23.

Perry JC, Cooper S (1989) An empirical study of defense mechanisms. Arch Gen Psychiatry 46:444–452PubMed

24.

Perry JC (1990) Defense mechanism rating scale, 5th edn. Cambridge University, Boston

25.

Perry JC, Kardos ME, Pagano CJ (1993) The study of defenses in psychotherapy using the defense mechanism rating scales (DMRS). In: Ehlers W, Draguns JG (eds) The concept of defense mechanisms in contemporary psychology. Springer, Berlin Heidelberg New York, pp 122–132

26.

Perry JC (2001) A pilot study of defenses in adults with personality disorders. J Nerv Ment Dis 1:651–660CrossRef

27.

Perry JC, Guelfi JD, Despland JN, Hanin B (2004) L’étude empirique des mécanismes de défense est-elle possible? In: Perry J.C., Guelfi JD, Hanin B, Despland JN (eds) Echelle d’évaluation des mécanismes de défense. Traduction et adaptation française du defense mechanism rating scales. Masson, Paris, pp 1–32

28.

Razavi D, Delvaux N, Marchal S, De Cock M, Farvacques C, Schlachmuylder JL (2000) Testing health care professionals’ communication skills: the usefulness of highly emotional standardized role-playing sessions with simulators. Psychooncology 9:293–302PubMedCrossRef

29.

Skodol AE, Perry JC (1993) Should an axis for defense mechanisms be included in DSM-IV? Compr Psychiatry 34:108–119PubMedCrossRef

30.

Stiefel F, Despland JN, Favre N, Guex P (2004) Effects of communication skills training on oncology clinicians’ communication styles and defense mechanisms. Oncosuisse (OCS-01595-08-2004)

31.

Stiefel F, Favre N, Despland JN, de Roten Y (2006) Communication skills training in oncology: it works—a review of the literature. In: Stiefel F (ed) Communication in cancer care. Springer, Berlin Heidelberg New York (in press)

32.

Vaillant GE, Bond M, Vaillant CO (1986) An empirically validated hierarchy of defense mechanisms. Arch Gen Psychiatry 43:786–794PubMed

Titel: Psychodynamic aspects of communication skills training: a pilot study
verfasst von: Nathalie Favre
Jean-Nicolas Despland
Yves de Roten
Martin Drapeau
Mathieu Bernard
Friedrich Stiefel
Publikationsdatum: 01.03.2007
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 3/2007
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-006-0150-6

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Psychodynamic aspects of communication skills training: a pilot study