Identifying and responding to depression in adult cancer patients: evaluating the efficacy of a pilot communication skills training program for oncology nurses.

Depression is a common response among cancer patients to their diagnosis and treatment; however, it goes undetected by healthcare providers in about 50% of cases. Communication skills training has been suggested as means to help nurses detect and respond to patient depression. We developed and pilot tested a communication skills training workshop based around 6 strategies. The training program consisted of 2 half-day experiential workshops that included didactic teaching, exemplary video, and role play. The aim of the study was to evaluate the effectiveness of the communication skills training. Fifteen nurses were recruited from the ambulatory nursing service at (redacted). Standardized patient assessments were used to measure strategy uptake. The presence of each strategy was rated on a 4-point scale from "not attempted" to "successfully attempted." Nurses also completed evaluations of the training program. The nurses attempted 3 of 6 strategies more commonly after training, and a trend to significance was observed in a fourth strategy. The nurses reported more confidence to deal with patient depression and had greater self-efficacy. This short training program demonstrated success in improving nurse communication skills and confidence in dealing with patient depression. A larger trial of the training is planned.

Functional status after primary surgical therapy for squamous cell carcinoma of the base of the tongue.

INTRODUCTION: Quality-of-life analysis is essential in determining the eventual outcome after treatment for head and neck cancer. This is particularly important when functional sequelae of treatment cause significant morbidity. The purpose of this study is to evaluate the functional status of a group of patients who had undergone primary surgical therapy for squamous cell carcinoma of the base of the tongue. METHODS: At our institution from 1979 to 1993, we identified 93 patients who had undergone resection of the base of the tongue as primary treatment for squamous cell carcinoma. Patients who required laryngectomy were excluded from this group. Forty-eight survivors were identified, and the questionnaires included the Performance Status Scale for Head and Neck Cancer Patients (PSS) and the Karnofsky Performance Status Scale (KPS). The data were reported numerically, with 0 representing the worst score and 100 representing the best score. RESULTS: Twenty-six patients completed the questionnaires. There were 19 men and 7 women. Their mean survival time was 8.6 years. Two patients had their primary tumors staged as T1, 17 patients had T2, and 7 patients had T3 disease. When evaluating the normalcy of diet, the mean score for the whole group was 73.1 (range, 20-100), the mean score for understandability of speech was 80.8 (range, 50-100), and the mean score for eating in public was 79.8 (range, 0-00). The mean KPS was 90 (range, 60-100). When comparing early (T1 and T2) with advanced (T3) disease, there were no significant differences in PSS and KPS. When comparing younger (<50 years) with older (>50 years) patients, there were no significant differences in PSS scores. Younger patients had a significantly higher KPS than older patients: mean, 97.5 vs 86.4 (p <.02). CONCLUSIONS: The long-term functional status for these patients who had undergone resection of a significant portion of the base of their tongue was good. The outcome did not seem to be related to either the stage of the lesion or the age of the patient. More studies are needed to examine the functional outcome of this patient population.