Communication strategies in doctor-patient-conversations when cancer patients are anxious or depressed

Abstract

Background: Many cancer patients suffer from psychological stress such as anxiety and depression during the course of their disease and treatment, but sometimes also years after completion of treatment. Aim: Based on the current state of research, this review provides information on how symptoms of anxiety and depression can be recognized during doctor–patient interactions, classified in terms of severity, alleviated with the help of adequate communication, and how other experts can be involved if necessary (stepped care). Results: Validated screening instruments are available for a preliminary assessment of anxiety and depressive symptoms. These instruments can be easily used in personal doctor–patient conversations. Patient-centered communication helps to alleviate patient anxiety and depression in conversations of regular oncology care. This patient-centeredness can be promoted during communication by providing adequate information, supporting patient autonomy, and promoting a tolerance for uncertainty. Specifically, this can be achieved through anxiolytic and antidepressant communication strategies and techniques such as pacing and leading, reorientation exercises, and recourse to mastery. Furthermore, the article focuses on the COMSKIL model, which provides a theoretical framework for concrete communication techniques. It is also available as a communication training program for oncology professionals. Against the background of the stepped care approach, it is helpful to be able to inform patients about psycho-oncological care offers on site, if necessary.