PRINCIPLE 6: Communication

PRINCIPLE 6: Communication

Everyone employed in the healthcare system is responsible for ensuring the communication needs of patients, their families and carers are met.

Good and open communication is a key principle of care for cancer patients. This includes communication between oncology and primary care health professionals and with patients. General practitioners should be involved in care from the point of diagnosis, and patients should be encouraged to maintain a relationship with their general practitioner through all stages of cancer care. Communication should be regular and timely.

Attendance of a family member or carer at clinical appointments is beneficial for many patients, as the family member or carer can provide informational and emotional support. General practitioners and clinicians should encourage and support the involvement of family members and carers by providing an inclusive and supportive consultation environment (Laidsaar-Powell et al. 2018a). Laidsaar-Powell et al. provide evidence-based guidance on how to support family member or carer involvement in consultations (Laidsaar-Powell et al. 2018a, 2018b).

Every person with cancer will have different communication needs, including cultural and language differences. When anyone involved in treatment communicates with patients, they should be truthful and transparent but aware of cultural and psychological sensitivities. In communicating with patients, healthcare providers should undertake to:

  • empower patients to be active in treatment discussions
  • use professionally trained interpreters if required – for example, when communicating with people from culturally diverse backgrounds whose primary spoken language is not English and for people with a hearing impairment (visit the Translating and Interpreting Services website for more information on interpreter and language services)
  • use culturally sensitive and appropriate forums of communication for people from culturally diverse backgrounds and Aboriginal and Torres Strait Islander people, as appropriate
  • provide appropriate information for people from culturally diverse backgrounds
  • provide information on community-based supportive care services and resources to patients and their families and carer
  • identify the patient’s substitute treatment decision-maker to ensure they are involved in relevant discussions
  • ensure patients, their families or their carers have the opportunity to ask questions
  • seek consent before conveying information between health professionals or healthcare teams or with family and carers
  • be respectful if a patient seeks a second opinion from another health professional
  • ensure patients do not have to convey information between areas of care (it is the provider’s and healthcare system’s responsibility to transfer information between areas of care)
  • communicate in plain language (avoiding complex medical terms and jargon)
  • ensure information is communicated at a level relevant to the patient’s health literacy and that of their families and carers (ACSQHC 2020)
  • use tools, diagrams and aids as appropriate (Gilligan et al. 2017)
  • ensure the patient is aware of how to access electronic patient information, where appropriate
  • allow enough time for communication, especially when conveying complex or sensitive information such as an initial diagnosis
  • check the patient’s and/or their family or carer’s understanding by asking the patient and/or their family or carer to say in their own words what has been conveyed.

Healthcare providers should also consider offering patients a question prompt list before a consultation and recordings or written summaries of their consultations afterwards. Question prompt lists are effective in improving communication and the psychological and cognitive outcomes of cancer patients. Recordings or summaries of key consultations improve patients’ recall of information and satisfaction (Hack et al. 2012). Written care plans, treatment summaries, survivorship care plans and advance care directives are effective records and communication tools.

Communication skills training programs that use role-play to develop skills and observe patient interactions to provide feedback, should be available to health professionals at every level of practice (Gilligan et al. 2017).

Communication skills training programs and resources can be found on the following websites:

Telehealth has become an increasingly acceptable alternative to face-to-face consultations. When using telehealth, the team must consider what is best for the patient, including the patient’s preferences of the patient. A face-to-face consultation should be the first option, if it is safe, when delivering critical diagnosis information, a change in therapy or prescribing intensive treatment. If this is not an option, a video consultation should be considered, and the patient should be encouraged to have a support person with them to assist (Cancer Australia 2020).