ABSTRACT
BACKGROUND: The COVID-19 pandemic has had and will continue to have a disproportionate effect on the most vulnerable. Public health messaging has been vital to mitigate the impact of the pandemic, but messages intended to slow the transmission of the virus may also cause harm. Understanding the areas where public health messaging could be improved may help reduce this harm. AIM: To explore and understand health communication issues faced by those most likely to be impacted by the COVID-19 pandemic. DESIGN & SETTING: A qualitative study using online surveys. The area of focus was Fife, a local authority in Scotland, UK. METHOD: Two consecutive surveys were conducted. Survey 1 explored the observations of support workers and Facebook group moderators, and focused on key issues faced by service users, as well as examples of good practice (n = 19). Survey 2 was aimed at community members, and focused on issues regarding access to and communication around access to primary care (n = 34). RESULTS: Survey 1 found broad issues around communication and access to primary care services. Survey 2 emphasised key issues in accessing primary care, including: (a) the lengthy process of making appointments; (b) feeling like a burden for wanting to be seen; (c) a lack of confidence in remote triaging and consultations; and (d) not knowing what to expect before getting an appointment. CONCLUSION: Clear issues regarding access to primary care were identified. The new understanding of these issues will inform a co-creation process designed to develop clear, actionable, and effective public health messages centred on improving access to primary care.
ABSTRACT
OBJECTIVES: Many cancer patients experience high levels of anxiety and concern during radiotherapy, often with long-lasting effects on their well-being. This systematic review aims to describe and determine the effectiveness of communication skills training (CST) for the radiotherapy team (RT) to improve conversations in this setting and to support patients with emotional concerns. DESIGN: Systematic review. INTERVENTIONS: CST for RT members. DATA SOURCES: On 17 April 2018, databases Medline, Embase, Scopus and PsycNET were searched. ELIGIBILITY CRITERIA, POPULATION, INTERVENTION, COMPARISON, OUTCOMEPICO: Quantitative and/or qualitative articles were included that evaluate the effect of a CST for RT members (vs no CST) on communication behaviours and patients' emotional concerns. DATA EXTRACTION AND SYNTHESIS: Articles were appraised using the mixed-methods appraisal tool, and a narrative synthesis was performed. RESULTS: Of the nine included articles, five were randomised controlled trials, three were mixed-methods and one used repeated measurements. Four of the five different CST programmes managed to increase emotional communicative behaviour from the RT, and all studies measuring patient communicative behaviour found an improvement in at least one of the hypothesised outcomes. Two studies examining patient anxiety and concerns found a positive effect of the CST, although one found a negative effect; two other studies without a positive effect on mood made use of both empathic CST and tools. CONCLUSIONS: There are promising indications that CST can be successfully introduced to improve emotional conversations between RT members and patients. With the right support, the RT can play an important role to help patients cope with their emotional concerns. Future work is necessary to confirm initial promising results and to ensure the learnt communication skills are sustained.
