Towards better communication in cancer care: a framework for developing evidence-based interventions

Patient Educ Couns. 2004 Oct;55(1):32-9. doi: 10.1016/j.pec.2003.07.001.


Increasing recognition of the complexity and difficulty of communication in patient care has led to a burgeoning but chaotic literature that tends to be incomplete on any one topic. A co-ordinated, planned approach is required to facilitate the rapid development and implementation of evidence-based interventions in this area. We propose a seven-stage model of communication research that is designed to provide clear directions to improve communication in cancer care. The stages are: (1) identification of communication difficulties; (2) documentation of patient and clinician views; (3) identification of practices associated with better outcomes; (4) the development of evidence-based guidelines and interventions; (5) testing the effectiveness of the intervention in changing current practice and improving patient outcomes; (6) dissemination of the effective interventions; and (7) broad adoption of the intervention. Examples are provided for each stage of research to elucidate the type of study proposed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Attitude of Health Personnel
  • Attitude to Health
  • Communication*
  • Data Collection
  • Documentation
  • Evidence-Based Medicine / organization & administration*
  • Health Promotion
  • Humans
  • Information Dissemination
  • Models, Psychological*
  • Needs Assessment
  • Neoplasms / psychology*
  • Outcome Assessment, Health Care / organization & administration
  • Physician-Patient Relations*
  • Planning Techniques
  • Practice Guidelines as Topic
  • Research Design*
  • Total Quality Management / organization & administration