Occupational Diseases

Behaviors and Mental Disorders

All Conditions

Occupational Stress

Burnout, Psychological

Stress, Psychological

Behavioral Symptoms

Each oncologist will have a total of three intervention days with a psychologist sitting in and observing the doctor-patient consultations and subsequently providing feedback.

Oncologists in the control group will conduct consultations as usual.

On-site supportive communication training

Kerstin Kiis Antonsen, MD

The goal of this randomized, controlled clinical trial is to test a new concept for communication skills training (on-site supportive communication training (on-site SCT) in cancer care. The study aims to determine the impact of on-site SCT on patients' rating of oncologists' communication abilities.

Oncologists participating in the study will be randomly allocated to the intervention or control group. In the intervention group each doctor will have a total of three intervention days at intervals of 3-4 weeks. On an intervention day, a psychologist will sit in and observe doctor-patient consultations. After the first consultations, 30 minutes are allocated for feedback to the doctor by the psychologist. After the last consultation of the day, 60 minutes are allocated for thorough feedback and establishment of learning goals to focus on until the next intervention day. Doctor's in the control group will conduct communication as usual.

Researchers will compare the control and intervention groups to see if patients' rating of doctors' interpersonal and communication skills increase when the doctors have participated in on-site SCT. The 15-item Communication Assessment Tool (CAT) will be used.

It will also be investigated whether on-site SCT increases the doctors' rating of themselves in relation to communication efficacy and job satisfaction and decrease their experience of burnout.

Oncologists carry a heavy responsibility when delivering information to cancer patients and helping them navigate through decisions about life-altering treatments, survivorship, and end-of-life care. Comprehensive person-centered psychosocial cancer care should be adapted to the individual patient, which is obviously a challenging task (Dilworth, et al. 2014). Individualized and empathic communication, on the other hand, is of substantial importance to patient satisfaction, adherence to treatment, empowerment, and the ability to navigate in the disease trajectory (Gattellari, et al. 2001; Stewart 1995; Vogel, et al. 2009).

The quality of the communication in medical care has been shown to influence health outcomes, as it increases the risk of unnecessary treatment and is linked to insufficient pain relief and higher anxiety levels (Thorne, et al. 2005). Therefore, considerable effort has been dedicated to interventions that may improve the communication skills of healthcare professionals involved in cancer care (Moore, et al. 2018). The primary purpose has been to improve the quality of the doctor-patient-communication including the doctors' interpersonal skills.

Previous papers have suggested direct feedback on observed situations as an ideal method for improving communication skills (Anderson 2012; Burgess, et al. 2020), but to the best of our knowledge, no randomized clinical trials have used patient feedback during on-site training. Studies on communication skills training courses with recorded consultations/role-play have shown significant effect on key communication skills (Fallowfield, et al. 2002) and increased self-efficacy (Ammentorp, et al. 2007). Two studies have demonstrated long-term maintenance of acquired skills (Finset, et al. 2003; Gulbrandsen, et al. 2013). Until now, no effect on burnout has been demonstrated (Bragard, et al. 2010a; Bragard, et al. 2010b).

Clinical supervision and training aims to develop clinical practice and provide a protected space to allow an educational and reflective process to occur. Although there is still no empirical definition of the term supervision (Milne 2007), in 2004 Bernard and Goodyear defined it as "an intervention provided by a more senior member of a profession to a more junior member or members of that same profession"(Bernard 2004). On this premise, psychologists cannot formally supervise doctors and other terms must be used. In this project we therefore use the term "on-site supportive communication training" (on-site SCT) when referring to the intervention given by the psychologists.

Psychologists have a long tradition of working with communication, creating a reflective learning space, making observations and providing feedback. It is therefore highly relevant to use dedicated psychologists to investigate the effect of on-site SCT on the doctors' communication and on their experienced level of self-efficacy, satisfaction and burn-out.

Oncologists will be randomized between the intervention and usual practice.

On-site Supportive Communication Training in Doctor-patient Communication

On-site Supportive Communication Training in Doctor-patient Communication: A Randomized, Controlled Trial

Patients rate the doctor's communication skills right after the consultation.

The Self-efficacy in Health Communication tool consists of 12 questions eliciting the healthcare professionals' perceived self-efficacy in communication with patients using a 10-point scale from "very uncertain" (1) to "very certain" (10).

The reply options in relation to burnout range from 1 (To a very high degree/always), to 5 (To a very low degree/never-almost never)

Job satisfaction is measured in Denmark every other year at the nation-wide employee satisfaction survey, which survey offers a large amount of comparable data. Five items directly concerning job satisfaction will be extracted from the survey.

Zealand University Hospital

Aalborg University Hospital

Vejle Hospital

In the experimental condition, the two significant caregivers of the child or the individual caregiver receive the intervention composed of an informational booklet and a psychological intervention. The intervention consists of four sessions, centered on supporting the child in the context of parental cancer principally through communication.

Assessments are conducted at two periods : before and after the intervention.

In the control condition, the participants receive the informational booklet before being registered in a waiting list for the psychological intervention. The intervention should ideally last two months.

Assessments are conducted at 9 weeks of interval.

A psychological intervention including 4 sessions to assess how participants communicate with their children about the disease and take stock of their questions and difficulties. To identify children's reactions and needs. Practical situation are analyzed and worked through role play centered on communicational difficulties to enhance communicational self-efficacy and mutual support among participants. Emotional regulation strategies are learned through relaxation exercises. A relaxation booklet is given to the participants to practice at home too. Moreover, all participants receive an informational booklet containing age-appropriate recommendations on communication with children about cancer.

Parental guidance

Razavi

Background:

Cancer has a significant short and long-term impact on the family. Children of cancer patients may suffer from emotional, behavioral or somatic difficulties. Following the cancer diagnosis, many parents report being concerned about the impact of the illness on their children and how to communicate about the illness. In addition, they feel less able to meet the needs of their children and have difficulties regulating their emotions in response to their children's reactions.

Methods:

A randomized controlled trial was designed to assess the efficacy of a parental guidance intervention centered on communication with children in the context of a parental cancer.

This psychological intervention is designed to help parents and significant caregivers of the children. The participants are randomly assigned to either an intervention group (experimental group) or a waiting list group (control group).

The participants fill out self reported questionnaires that assess the parental self-efficacy in communication, mutual social support, communicational behaviors' with children, parenting concerns,communicational difficulties with children, knowledges about communication with children in oncological context, socio-demographical status, medical situation, psychiatric history, social difficulties and emotional state of the participants and children. The semi-structured interview with participants assesses their day to day communication with the children and the difficulties related to this communication. Those questionnaires are completed at baseline and post treatment (experimental group) and 9 weeks after baseline (control group).

This parental guidance consists of a weekly 4-session intervention. The aim of the sessions are to provide child support in the oncological context, mainly through communication.

Discussion:

This parental guidance would lead to improvements in knowledge, communication, parental self-efficacy and emotional regulation associated with child support.

Introduction :

Parents raise many questions about the impact of the cancer on their children and on the communication with them about the disease. For many of them, the cancer impact their parental self-efficacy. This decrease of self-efficacy is related to difficulties to communicate openly with children and to regulate emotions in response to the feelings, reactions and questions of their children. In the same way, some parents report a lack of knowledge on how to support their children. They express doubts concerning the way they speak about cancer with their children.

Objectives of the study :

The primary objective of this study is to test the contribution and effectiveness of a psychological intervention in relation to the delivery of an informational booklet regarding participants' communication with the child in the oncology context. This intervention should increase participants' sense of communicative competence and communicationnal behaviors with children.

The secondary objectives is to evaluate the improvement of the participants' regarding the knowledge of how to support a child facing a parent's cancer, the emotional regulating capacity associated with participants' communication with the child, the evolution of the participants' concerns about the child. When the intervention is carried out in a dyad, it should also improve mutual support between participants.

This intervention is designed to help parents and significant caregivers of the children. It is focused on child support in the oncological context, and mainly on the communication between parents and their children. This intervention consists in a brief psychological intervention focused on improving knowledge, communication, parental self-efficacy and emotional regulation associated with child support. The intervention will be customized and tailored to each family.

Participants :

All significant caregivers of a child aged between 3 and 18 and who's facing parental cancer can be included in the study. A significant caregiver is a person who takes care of children at a practical, educational and emotional level (mostly parents, step parents, legal guardians, grandparents...). The whole study (assessment procedure and psychological intervention) is realized with one or two persons involved in child support. A consent form will be completed and signed by the adult participants.

Study design :

The effectiveness of the parental support intervention is assessed through a longitudinal two arms, randomized controlled trial. The psychological intervention is proposed to the main caregivers of children confronted to parental cancer.

In the experimental condition, the two significant caregivers of the child or the individual caregiver receive the intervention composed of an informational booklet and a psychological intervention. The intervention consists of four sessions, centered on supporting the child in the context of parental cancer mainly through communication.

In the control condition, the participants receive the informational booklet before being registered in a waiting list for the psychological intervention. The intervention should ideally last two months. Assessments are conducted at two periods (T1 and T2) : before and after the intervention for the experimental group and at 9 weeks of interval for the control group. The evaluation of the intervention is conducted through questionnaires completed by participants and a semi-structured interview.

Intervention :

The intervention consists in a brief psychological intervention including four sessions, centered on supporting the children in the context of parental cancer through communication. The content of the intervention is adapted to the specific situation of each family, their difficulties and their needs.

The first session is dedicated to the assessment of how participants communicate with their children about the disease and to take stock of their questions and difficulties. In this session, the family situation and the medical context are also discussed and the parental skills are identified. The other sessions are essentially focused on the identification of children's reactions and needs in the context of cancer and on the communication with children about the disease. Practical situation are analyzed and worked through role play centered on communicational difficulties. Participants must actively participate in the intervention. Specific techniques will be used with the participants to "co-construct" personalized communication with their child and to support its implementation. This active participation aims to enhance communicational self-efficacy and mutual support among participants. During the intervention, emotional regulation strategies are also transmitted to the participants through relaxation exercises in order to cope with the emotions felt in these particular contexts. A relaxation booklet is given to the participants to practice at home the relaxation exercises learned during the sessions. Moreover, all participants (experimental and control conditions) receive an informational booklet containing age-appropriate recommendations on communication with children about cancer. This booklet aims to improve knowledge of participants on how to support their children.

Assessment procedure :

Assessments are conducted at two periods (T1 and T2) and consist of questionnaires and a semi-structured interview with each participant. For the assessment, participants must refer specifically to only one child in their circle, aged between 3 and 18 years. If several children meet these criteria, participants determine the one for whom they have the most questions regarding communication with him/her about the illness. The child thus identified serves as a reference for T1 and T2 in order to standardize the evaluation procedure as much as possible.

Some questionnaires assess the primary outcome of the study : parental self-efficacy in communication, communicational behaviors' with children. Other questionnaires assess the secondary outcome of the study: Emotional regulation, mutual support between participants, communicationnal difficulties with children, parenting concerns, knowledges about communication with children in oncological context. Many questionnaires are specifically created by the investigator's team. Other questionnaires assess control variables: the socio-demographical status, medical situation, psychiatric history, social difficulties and emotional state of the participants and children. The semi-structured interview with participants assesses their day to day communication with the children and the difficulties related to this communication. Each semi-structured interview takes approximatively 20 minutes and is recorded and transcribed.

The sample size has been calculated a priori in order to detect the differences in the evolution of the two groups (experimental and control conditions) between T1 and T2.

The sample size calculation was done with the software G\*Power. The power analysis has been based on a previous pilot study assessing the efficacy of the intervention on patient. Self-efficacy score have been considered to perform the power analysis (Change over time in Experimental Group: Delta T2-T1 Mean = 0.9514; SD = 0.8043; Change over time Control Group is consider as zero). The effect size was 1.183 for a power of 0.90 in two-side. Based on this result but considering the small sample of the pilot study, the sample size calculation has been based on a 0.9% power, an effect-size of 0.9 and a two-sided α = 0.05 t-test. Considering this power analysis, 54 evaluable patients are therefore needed for the efficacy assessment. Considering a drop-out rate of approximately 10%, 6 patients should be moreover recruited. The aim of the study is therefore to recruit 60 patients.

The effectiveness of the parental support intervention is assessed through a longitudinal two arms, randomized controlled trial and the experimental condition, the two significant caregivers of the children or the individual caregiver receive the intervention composed of an informational booklet and a psychological intervention. In the control condition, the participants receive the informational booklet before being registered in a waiting list for the psychological intervention. The intervention should ideally last two months. Assessments are conducted at two periods : before and after the intervention for the experimental group and at 9 weeks of interval for the control group.

Parental Support Intervention in the Oncological Context

Children Facing Parental Cancer : a Randomized Controlled Study Evaluating the Efficacy of a Psychological Intervention to Support Parenting

Assessment through a self-reported scale created for the study and completed by the participants named "Sense of communicational competence with the child". The questionnaire is composed of 16 items. The scale represents the level of certainty regarding the proposed items. The questionnaire has a 10 points Likert scale. The scale ranges is from 0 to 10. 0 means " not at all certain " and 10 "quite certain". Change in the parental self-efficacy in communication is assessed by comparing the questionnaire completed in T1 with the one completed in T2.

Parental self-efficacy is also analyzed through a content analysis of the responses given by the participants in the semi-structured interview. The presence of words such as confident, capable or opposite will provide insight into the sense of parental self-efficacy. Comparing the responses in T1 with those in T2 will highlight the change of parental self-efficacy through the increase or decrease in the occurrence of a word.

Assessment through a content analysis of the responses given by the participants in the semi-directive interview. The main domains explore by the semi directive interview are: description of the communication, feelings during the communication and communicational behaviors. Comparing the responses in T1 with those in T2 will highlight the evolution of the communicational behaviors with the child.

Assessed through a validated self-reported scale: The Hospital Anxiety and Depression Scale (HADS). It is composed by two dimensions (anxiety and depression) and has a 4 point Likert scale that vary at each item. HADS provides a total score (0-42 range) by summing all item scores. A higher score reflects a higher emotional distress. Anxiety subscale score (0-21 range) is provided by summing all Anxiety-items. A higher score reflects more anxiety. Depression subscale scores (0-21 range) is provided by summing all Depression-items. A higher score reflects more depression.

Communicational difficulties are assessed through a self-reported scale created for the study and completed by the participants named "Communication difficulties with the child ". The scale is composed of 13 items which represents the level of truth regarding the proposed items. The questionnaire has a 4 points Likert scale. The scale ranges is from "yes" to "no ". The evolution of the communicational difficulties is assessed by comparing the questionnaire completed in T1 with the one completed in T2.

The Communicational difficulties with children are also analysed through a content analysis of the responses given by the participants in the semi-directive interview. The main domains explore by the semi directive interview are: description of the communication, feelings during the communication and communicational behaviors. Comparing the responses in T1 with those in T2 will highlight the evolution of the communicational difficulties.

Mutual support between participants is assessed through a self-reported scale created for the study and completed by the participants named "Mutual support between participants". The scale is composed of 8 items which represents the level of truth regarding the proposed items. The questionnaire has a 4 points Likert scale. The scale ranges is from "yes" to "no". The evolution of the mutual support between participants is assessed by comparing the questionnaire completed in T1 with the one completed in T2.

Parents' concerns are assessed through a self-reported scale created for the study and completed by the participants named "concerns about the identified child". The scale is composed of 14 items which represents the level of truth regarding the proposed items. The questionnaire has a 5 points Likert scale. The scale ranges is from "Not at all concerned" to "deeply concerned". The evolution of parenting concerns is assessed by comparing the questionnaire completed in T1 with the one completed in T2.

Assessment through a self-reported scale created for the study and completed by the participants named "Knowledge of the child's level of understanding about cancer". It is composed by 10 items that describe a child's ability to understand cancer disease. The questionnaire has a 2 points Likert scale, "yes" or "no". The expected answers are 6 yes and 4 no. The answers will show the level of knowledge of the participant (good, medium or bad) regarding the understanding of children. The evolution of the knowledges of the participant about the understanding of children in oncological context is assessed by comparing the questionnaire completed in T1 with the one completed in T2.

Centre de Psycho-Oncologie (CPO)

Erasme University Hospital

Jules Bordet Institute

Université Libre de Bruxelles

Aurore Liénard

Aurore Lienard, Coordinator of the Psycho-Oncology Clinic at the Bordet Institute

Patient-caregiver dyads will immediately attend the Dyadic communication reinforcement intervention. For both groups, first assessment time take place just after the enrollment, before the randomization. For this group, second assessment time take place 2 weeks post-intervention. Pre-post assessments consist in self-reported scales assessing emotional distress, individual coping, cancer-related dyadic communication frequency, satisfaction, self-efficacy and coping.

Patient-caregiver dyads are in a waiting condition for 6 weeks. They will attend the Intervention after the second assessment time if they want to. For both group, first assessment time take place just after the enrollment, before the randomization. For this group, second assessment time take place 6 weeks after first assessment time. First and second assessment consist in self-reported scales assessing emotional distress, individual coping, cancer-related dyadic communication frequency, satisfaction, self-efficacy and coping.

Psycho-educative and behavioral intervention centered on cancer-related dyadic communication

Dyadic Communication Reinforcement Intervention

Darius Razavi, MD, PhD

Background: To face cancer-related stress, patients and caregivers activate individual and dyadic coping responses. Opened communication, adequate involvement, reciprocal supportive roles, self-disclosure and responsiveness enhance dyadic coping. Nevertheless, little is known about the optimal content of dyadic interventions designed to improve dyadic communication.

Methods: A randomized controlled trail was designed to assess the efficacy of a dyadic intervention centered on a cancer-related communication reinforcement. Patient-caregiver dyads are randomly assigned to either an intervention group or a waiting list group. Patients and caregivers complete self-reported scales that assessed emotional distress, individual coping, cancer-related dyadic communication frequency, satisfaction, self-efficacy and coping at baseline and post-treatment (intervention group), or 6 weeks after baseline (waiting list group). This dyadic communication reinforcement intervention (DCRI) consists of a weekly 4-session intervention. This intervention includes specific communication tasks aiming the improvement of some cancer-related dyadic communication competencies such as concerns disclosure and request for support.

Discussion: DCRI would lead to improvements in cancer-related dyadic communication self-efficacy, cancer-related dyadic communication satisfaction and dyadic coping.

1. Aim of the trial: A randomized longitudinal study assessing the efficacy of a dyadic communication reinforcement intervention (DCRI) between cancer patients and their caregivers. Efficacy of the DCRI will be assessed by the analysis of changes over time in both patients and caregivers self-reported questionnaires/scales measures.
2. Participants: Patients and caregivers are recruited from oncology clinics at Erasme Hospital and Jules Bordet Institute (Brussels, Belgium). Recruitment and all study procedures were approved by a central ethics committee (Erasme - ULB Ethics Committee) and all participants are providing written informed consent.
3. Study Design: Participants are randomly assigned to the experimental group, consisting of the DCRI, or to the control group, consisting of a waiting list. Dyads in the waiting list can complete the DCRI after the last assessment if they want to. Investigator, psychologist in charge of the intervention and participants are blinded for this randomization. Dyads completed a follow-up assessment (T2), either 2 weeks after the DCRI in the experimental group or 6 weeks after baseline in the control condition. All assessment time were completed either at the outpatient clinic or at home.
4. DCRI content: DCRI aims communication reinforcement by a weekly 4-sessions program. DCRI is manualized and is conducted by an experienced psychologist (same psychologist for all participating dyads). Sessions focus on reciprocal cancer-related stress communication between patients and their caregivers using a specific communication task that promotes self-disclosure and request for support. All sessions are divided into four times: (1) session introduction, (2) first communication task, (3) second communication task and (4) session conclusion.

(1)Session introduction: Firstly, psychologist assesses if any significant moment occurred before the actual session and let dyad members talk about it if they want. Secondly, psychologist addresses some theoretical information about the session subject. First and second session subject is about personal cancer-concerns disclosure and close one supportive response to this disclosure. Third and fourth session subject is about personal request for support to face a cancer-related stress and close one response to this request for support. In the first and second session, psychologist therefore discusses the importance of sharing stress appraisal, stress describing, thoughts and emotions expressing and how to be supportive in responding. In the third and fourth session, psychologist discusses the importance of the personal needs communication and the clarity of the request for support to be well understood by the partner.

(2 \& 3) First and second communication task: This communication task is divided into an audio-recorded communication exercise and the debriefing of this communication exercise. In each session, there are therefore two communication tasks (two exercises and two debriefing). An exercise lasts 5 minutes and psychologist stays with the dyad but does not intervene during it. This exercise consists in patient and caregivers embody a specific role: "discloser" and "listener". Each role is associated with specific instructions. Exercise (and therefore task) is performed twice a session to let patient and caregiver experiment each of these roles. In the first and second session, the discloser has to express a personal cancer-related stress to the listener. The listener has to listen and respond supportively to this expressed cancer-related stress. In the third and fourth session, the discloser has to ask for help about a personal cancer-related stress to the listener. The listener has to listen and respond to this request for support. The exercise debriefing consists in the listening, in session, of the exercise record. After the listening, psychologist asks to the listener what kind of the discloser communicational behavior help him to understand the expressed cancer-related stress. Psychologist asks also to the discloser what kind of the listener communicational behavior help him to feel supported. After that, psychologist reinforces each positive communication strategy used by the discloser and the listener.

(4) Session conclusion: Psychologist summarizes the two communication tasks and notes all positive communication strategies used by the patient and the caregiver in self-disclosing/responding (first and second session) or request for support/responding to request for support.

5. Assessment procedure: Patients and caregivers are assessed by self-reported measures at baseline (T1) (after enrollment) and 2 weeks after the intervention (in the experimental group) or 6 weeks after baseline (T2) (in the control group). Patients and caregivers complete exactly the same self-reported questionnaires and scales. Patients had a medical information questionnaire in addition at baseline and study personnel rated their performance status, based on the Karnofsky Performance Status Scale, at T1 and T2. Other specific oncologic information was collected by medical record review.

At T1, demographic questionnaire assesses gender, age, cultural background, education level, native speaking, professional situation, familial situation (children) and psychiatric history. At T1, dyadic information questionnaire assesses relationship type, relationship length, living situation and contact frequency between patients and caregivers.

Patients and caregivers complete following self-reported scales in T1 and T2: (1) Cancer-related dyadic communication frequency, (2) cancer-related dyadic communication satisfaction, (3) cancer-related communication self-efficacy, (4) Dyadic Coping Inventory, (5) Hospital Anxiety and Depression Scale and (6) Ways of Coping Checklist.

6. Statistical Analysis: Statistical analysis consisted in a comparative analysis of groups at baseline using parametric and nonparametric tests as appropriate (Student's t test, Mann-Withney U test or Chi-squared test). Patients and caregivers outcomes at baseline and after the DCRI, or after the waiting period, were compared using repeated measures analysis of variance (MANOVA). Time and group-by-time effects were processed using MANOVA. Effect size will be report with eta-squared (η²) given by MANOVA. All tests were two-tailed, and the alpha was set at 0.05. All analyzes were performed using SPSS®, version 25.

7. Data Quality Control: There are 6 study collaborators: (1) recruitment manager, (2) investigation coordinator, (3) assessor, (4) psychologist in charge of the intervention, (5) data manager and (6 \& 7) two data assistants.

1. Recruitment manager manages the recruitment process. Every recruitment steps have been approved by institution ethics committee. Patients phone numbers meeting inclusion criteria are provided by the medical staff to the recruitment manager only. These phone numbers are destroyed after the recruitment phase. Recruitment manager calls each patient to give them basic information about the study. If they are interested in, recruitment manager calls the designated caregiver with the patient consent. If the caregiver agrees too, recruitment manager makes an appointment to provide a written informed consent.
2. Investigation assistant provides the randomization number for each participating dyad to the data manager. He books all DCRI session for the psychologist in the good time lapses (regarding the group).
3. Assessor assists participants in questionnaires and scales if they need it and he rates each patient by a Karnofsky score. A numerical copy is made for each assessment. This copy is put on a encrypted hard drive disk. Paper version is given in person to data manager. Paper versions are stored in a secure location.
4. Psychologist conducts the DCRI
5. Data manager manages randomization number, securing data storage, data encoding and encoding checking.
6. Data assistants encode data provide by the questionnaires and scales. They only have a participant ID and no randomization information. Double encoding, checked by the data manager, reduces encoding error.

This 7-persons functioning guarantees complete masking procedure from recruitment to encoding.

Randomization allocation is given only at the data manager. Participant, care provider and assessor do not know in which group participants are allocated

Efficacy of a Dyadic Cancer-related Communication Reinforcement Intervention

Cancer-related Communication Between Patients and Their Caregivers: A Randomized Controlled Trial Assessing the Efficacy of a Dyadic Communication Reinforcement Intervention (DCRI)

Cancer-related dyadic communication self-efficacy through a self-reported scale for patients and caregivers. The perceived dyadic communication self-efficacy was measured by a 6-dimension scale: Dyadic Communication Competencies. Each dimension is divided into 5 items. Subject has to rate each item on a 0-100 range (0 = not certain; 100 = absolutely certain) to report how he is certain to matser the communication competency. A total score (ranging 0-100) for each dimension is computed by making the mean of all item scores. A higher score reflects a higher perceived communication self-efficacy.

Cancer-related dyadic coping through a validated self-reported scale for patients and caregivers: Dyadic Coping Inventory (DCI). It is composed of the following six different dimensions: stress communication, supportive dyadic coping, delegated dyadic coping, negative dyadic coping, common dyadic coping and evaluation of dyadic coping. The DCI has a 5-point Likert scale (1 = "Rarely"; 5 = "Very Frequently") and provides a total score (35-175) by summing all items. A higher score reflects a better dyadic coping.

Emotional distress levels through a validated self-reported scale for patients and caregivers: The Hospital Anxiety and Depression Scale (HADS). It is composed by 2 dimensions (anxiety and depression) and has a 4-point Likert scale that vary at each item. HADS provides a total score (0-42 range) by summing all item scores. A higher score reflects a higher emotional distress. Anxiety subscale score (0-21 range) is providen by summing all Anxiety-items. A higher score reflects more anxiety. Depression subscale scores (0-21 range) is providen by summing all Depression-items. A higher score reflects more depression.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
On-site Supportive Communication Training in Doctor-patient Communication	NCT05842083	Communication P... Communication, ... Communication R... Oncology Doctor Patient ... Job Stress Burnout Satisfaction, P... Efficacy, Self	On-site support...	18 Years - 100 Years	Vejle Hospital
Parental Support Intervention in the Oncological Context	NCT03905278	Parent-Child Re... Parenting Communication P...	Parental guidan...	3 Years - 18 Years	Université Libre de Bruxelles
Efficacy of a Dyadic Cancer-related Communication Reinforcement Intervention	NCT03723122	Cancer Communication P...	Dyadic Communic...	18 Years -	Université Libre de Bruxelles
Efficacy of a Dyadic Cancer-related Communication Reinforcement Intervention	NCT03723122	Cancer Communication P...	Dyadic Communic...	18 Years -	Université Libre de Bruxelles
On-site Supportive Communication Training in Doctor-patient Communication	NCT05842083	Communication P... Communication, ... Communication R... Oncology Doctor Patient ... Job Stress Burnout Satisfaction, P... Efficacy, Self	On-site support...	18 Years - 100 Years	Vejle Hospital
Efficacy of a Dyadic Cancer-related Communication Reinforcement Intervention	NCT03723122	Cancer Communication P...	Dyadic Communic...	18 Years -	Université Libre de Bruxelles

Spots Global Cancer Trial Database for communication programs