Consultation task stress in oncologists and palliative care physicians
Oncologists and palliative care physicians will be surveyed across Australia on aspects of communicating with cancer patients in medical consultations that they perceive as stressful. The project aims to identify stressors that may affect the quality of the doctor-patient interaction with findings informing the future development of interventions and organisational changes to improve physician coping and patient care. This survey forms a sub-component of a larger study commissioned by COSA, led by Prof. Afaf Girgis - Director of CHeRP - to explore professional burnout and psychosocial distress in those contributing to cancer care in Australia.

Funding: None

Discussing prognosis & end-of-life issues in palliative care; current practice & development of an evidence based training program
We have conducted focus groups with palliative care patients, and their carers, and health professionals working in palliative care, and obtained their views on ideal communication of prognosis. We have analysed audio-taped consultations to see how these issues are currently discussed. We are now conducting a systematic review of the literature in this area and developing evidence-based guidelines for communicating prognosis in the palliative care setting which will be reviewed by an international panel. A communication skills workshop will be developed and piloted focusing on this issue.

Funding: NHMRC Palliative Care Grant, Cancer Institute NSW Clinical Research Fellowship 

Discussing prognosis and treatment goals with patients with metastatic cancer: Evidence-based strategies
126 metastatic cancer patients seeing 30 oncologists at 12 outpatient clinics in N.S.W. Australia completed a survey eliciting: their preferences for prognostic information including type, quantity, mode of presentation and timing; anxiety and depression levels, information and involvement preferences, and preferred doctor style of communicating prognosis. Most metastatic cancer patients want detailed prognostic information but prefer to negotiate the extent, format and timing of this information they receive from their oncologist. The majority of patients also preferred a realistic and individualised approach from the cancer specialist when discussing prognosis. The sample was re-surveyed again 6 months later: Results are not yet available concerning changes in preferences over this time.

Funding: University of Sydney Cancer Research Fund and SESQUI

Routine implementation of question prompt lists
2 urban and 2 rural cancer centres were invited to routinely use question prompt lists (proven beneficial) for patients seeing a surgeon, medical or radiation oncologist or palliative care physician. Dissemination methods included receptionists, volunteer hospital staff, physicians, cancer care co-ordinators and project research assistants. Uptake rate was monitored, and views on the utility of the question prompt list were collated from patients and hospital staff involved. Barriers and facilitators to implementation were noted.

Funding: Cancer Institute NSW