Effect of a prediction tool and communication skills training on communication of treatment outcomes: a multicenter stepped wedge clinical trial (the SOURCE trial).

Background: For cancer patients to effectively engage in decision making, they require comprehensive and understandable information regarding treatment options and their associated outcomes. We developed an online prediction tool and supporting communication skills training to assist healthcare providers (HCPs) in this complex task. This study aims to assess the impact of this combined intervention (prediction tool and training) on the communication practices of HCPs when discussing treatment options. Methods: We conducted a multicenter intervention trial using a pragmatic stepped wedge design (NCT04232735). Standardized Patient Assessments (simulated consultations) using cases of esophageal and gastric cancer patients, were performed before and after the combined intervention (March 2020 to July 2022). Audio recordings were analyzed using an observational coding scale, rating all utterances of treatment outcome information on the primary outcome-precision of provided outcome information-and on secondary outcomes-such as: personalization, tailoring and use of visualizations. Pre vs. post measurements were compared in order to assess the effect of the intervention. Findings: 31 HCPs of 11 different centers in the Netherlands participated. The tool and training significantly affected the precision of the overall communicated treatment outcome information (p = 0.001, median difference 6.93, IQR (-0.32 to 12.44)). In the curative setting, survival information was significantly more precise after the intervention (p = 0.029). In the palliative setting, information about side effects was more precise (p < 0.001). Interpretation: A prediction tool and communication skills training for HCPs improves the precision of treatment information on outcomes in simulated consultations. The next step is to examine the effect of such interventions on communication in clinical practice and on patient-reported outcomes. Funding: Financial support for this study was provided entirely by a grant from the Dutch Cancer Society (UVA 2014-7000).

[Parents' experiences in a pediatric intensive care unit]. / Ervaringen van ouders op een afdeling intensive care voor kinderen.

In this paper an account is given of a research on how parents experience and react to their child's treatment in the Intensive Care Unit of the Academic Medical Centre of Amsterdam. The purpose of this research was to gain insight into how this period influenced parents and to make an inventory of the problems parents were being confronted with. Parents play a fundamental role in supporting their child which is not easy on an ICU because of the unknown and frightening environment. One of the reasons why this kind of study has been done into a descriptive/exploring style is because such research is practically new in the Netherlands. The main results will be described and some recommendations will be made how to improve the quality of the guidance of the parents on an ICU.

[Parental visiting and involvement in the neonatal intensive care unit]. / Bezoek en participatie van de ouders op de couveuse-afdelingen.

Out of 145 neonatal departments of Dutch hospitals 120 participated in an inquiry concerning parental visiting and involvement. The results point to the conclusion that involvement of the parents is a fact that concerns practically all departments. Parents are allowed much more than some ten years ago. However, talks with parents reveal that many of them are not satisfied by far concerning these matters. Therefore the value of this kind of study is in revealing social desirability rather than actual reality.