Smita C. Banerjee

Communication Skills Training for Oncology Professionals

PURPOSE To provide a state-of-the-art review of communication skills training (CST) that will guide the establishment of a universal curriculum for fellows of all cancer specialties undertaking training as oncology professionals today. METHODS Extensive literature review including meta-analyses of trials, conceptual models, techniques, and potential curricula provides evidence for the development of an appropriate curriculum and CST approach. Examples from the Memorial Sloan-Kettering Cancer Center CST program are incorporated. RESULTS A core curriculum embraces CST modules in breaking bad news and discussing unanticipated adverse events, discussing prognosis, reaching a shared treatment decision, responding to difficult emotions, coping with survivorship, running a family meeting, and transitioning to palliative care and end of life. Achievable outcomes are growth in clinicians self-efficacy, uptake of new communication strategies and skills, and transfer of these strategies and skills into the clinic. Outcomes impacting patient satisfaction, improved adaptation, and enhanced quality of life are still lacking. CONCLUSION Future communication challenges include genetic risk communication, concepts like watchful waiting, cumulative radiation risk, late effects of treatment, discussing Internet information and unproven therapies, phase I trial enrollment, and working as a multidisciplinary team. Patient benefits, such as increased treatment adherence and enhanced adaptation, need to be demonstrated from CST.

Role of Transportation in the Persuasion Process: Cognitive and Affective Responses to Antidrug Narratives

This study examined transportation effects of first- and third-person narratives as well as the role of transportation in the persuasion process. In particular, the authors evaluated the role of transportation in affecting cognitive and affective responses. Last, they addressed the relation between (a) cognitive and affective responses and (b) antidrug expectancies. Participants were 500 undergraduate students at a large northern university in the United Kingdom who were randomly assigned to 1 of 2 conditions: first- or third-person narratives on cocaine use. The results demonstrated that there was no difference between first- and third-person narratives in terms of transportation. However, overall, greater transportation was associated with more favorable cognitive responses, and more favorable cognitive response was associated with stronger anticocaine expectancies. In terms of affective responses, results indicated the mediating role of sadness and contentment in the association between transportation and anticocaine expectancies. In particular, increased transportation was associated with greater sadness and lower contentment. Lower sadness and contentment were associated with stronger anticocaine expectancies. Important theoretical and empirical implications are discussed.

Assessing Health Diagnosis Disclosure Decisions in Relationships: Testing the Disclosure Decision-Making Model

Illness affects millions of Americans each year, and the disclosure of health conditions can facilitate access to social support, in addition to other physical and physiological benefits. This article tests the Disclosure Decision-Making Model (DD-MM; Greene, 2009) to predict factors that influence the likelihood of disclosing (and past disclosure of) nonvisible physical or mental health-related information. One hundred eighty-seven (n = 187) people were recruited for a study to report on both disclosing and not disclosing a nonvisible health condition. Measured variables included information assessment, relational quality, anticipated reactions (support, relational consequences), confidence in response, disclosure efficacy, and disclosure (likelihood of disclosure and depth of disclosure). Structural equation modeling results supported many of the proposed hypotheses, with a great deal of similarity across models. Specifically, assessing information predicted efficacy, and to some extent relational outcomes. Closeness was related to response overall and to efficacy in one model. Response predicted outcome overall and likelihood of disclosure in one model. Finally, efficacy predicted likelihood of disclosure and depth of disclosure. The article discusses the implications of the findings for understanding information, relationship assessments, and efficacy in disclosing health diagnoses.

Comparing Normative, Anecdotal, and Statistical Risk Evidence to Discourage Tanning Bed Use

This study compared the efficacy of normative messages to other traditional persuasive messages using anecdotal or statistical risk evidence. Messages were compared regarding their impact on beliefs, attitudes, and normative perceptions regarding tanning bed use. Undergraduate students (N = 744) at a large Northeastern university were randomly assigned to 1 of 4 message conditions: normative, anecdotal, statistical risk, or no-message control. Results from this study indicate that, although evidence types do not directly influence behavioral intention, some do impact message perceptions, normative perceptions, severity, and health beliefs about the safety of tanning beds and their negative consequences. Normative evidence was superior to other evidence types in influencing normative perceptions of other college students’ and friends’ beliefs that tanning beds are safe, some messages ratings, and beliefs about health protection and consequences of tanning beds. Anecdotal messages were best at altering severity and amount of invested mental effort, but statistical messages overall performed the worst. Skin color effects and gender differences were also found.

The Role of Gender and Sensation Seeking in Film Choice

This study demonstrates the significance of individual difference factors, particularly gender and sensation seeking, in predict- ing media choice (examined through hypothetical descriptions of films that participants anticipated they would view). This study used a 2 (Positive mood/negative mood) × 2 (High arousal/low arousal) within-subject design with 544 undergraduate students recruited from a large northeastern university in the United States. Results showed that happy films and high arousal films were preferred over sad films and low-arousal films, respectively. In terms of gender differences, female viewers reported a greater preference than male viewers for happy-mood films. Also, male viewers reported a greater preference for high-arousal films compared to female viewers, and female viewers reported a greater preference for low-arousal films compared to male viewers. Finally, high sensation seekers reported a prefer- ence for high-arousal films. Implications for research design and importance of exploring media characteristics are discussed.

Ethnocentrism and Sensation Seeking as Variables that Influence Intercultural Contact-Seeking Behavior: A Path Analysis

Previous research findings suggest that sensation seeking may be a predictor of intercultural contact-seeking behavior. However, these findings do not take into account ethnocentrism, a variable that has been adversely associated with intercultural communication. Ethnocentrism is characterized as a way of seeing ones own culture as central to all others and evaluating other cultures based on ones own values. The present study explores how the introduction of ethnocentrism alters the relationship between sensation seeking (and related variables) and intercultural contact-seeking behavior by means of a path analysis. Four hypotheses were proposed, and all four were supported. The results suggest that ethnocentrism weakens the motivation to interact with people from other cultures and may even hinder high sensation seekers from forming intercultural friendships.

‘My friends love to tan’: examining sensation seeking and the mediating role of association with friends who use tanning beds on tanning bed use intentions

Abstract This paper explored how sensation seeking contributes to the likelihood of tanning bed use intentions both directly and indirectly through the way it shapes interaction with peers who use tanning beds and attitudes toward tanning bed. Eight hundred and ninety six (n = 896) male and female college students were recruited for the study. Measured variables included sensation seeking, association with friends who use tanning beds, attitudes toward tanning and tanning bed use intentions. Structural equation modeling was performed to test the hypotheses. In general, results supported the proposed hypotheses and documented that sensation seeking is indirectly associated with tanning bed use intentions through the mediation of association with peers who use tanning beds and attitudes toward tanning. The article discusses theoretical and methodological implications of the findings demonstrating the pathways of influence of sensation seeking on tanning bed use intentions.

Examining unsupervised time with peers and the role of association with delinquent peers on adolescent smoking

Abstract Introduction: This study explored the association between unsupervised time with peers and adolescent smoking behavior both directly and indirectly through interaction with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers. Methods: A cross-sectional survey was used for the study and included 248 male and female middle school students. Results: Results of structural equation modeling revealed that unsupervised time with peers is associated indirectly with adolescent smoking behavior through the mediation of association with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers. Discussion: Interventions designed to motivate adolescents without adult supervision to associate more with friends who engage in prosocial activities may eventually reduce adolescent smoking. Further implications for structured supervised time for students outside of school time are discussed.

Oncology nurses' communication challenges with patients and families: A qualitative study

The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions.

“You can't tell anyone but …”: Exploring the Use of Privacy Rules and Revealing Behaviors

This three-part study examines how privacy rules function to protect shared information from further revelation. Communication Privacy Management served as a theoretical framework to investigate issues related to boundary management. In the pilot study, college students (N = 409) described privacy rules and their use, and participants reported not further revealing the information when privacy rules were expressed by disclosers. In Study 1, participants (N = 167) reported on disclosing health-related information, and participants did not anticipate that recipients would further reveal especially when they used a privacy rule. In Study 2, dyads (dyad N = 257) reported on shared disclosure experiences, including both anticipated and actual boundary management. Study 2 findings include that privacy rules have limited effectiveness. The article discusses implications of privacy rule use when sharing private information.