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      Client and practitioner perspectives on the screening mammography experience

      research-article
      , MSc, DCR 1 , 2 , , , FRCR 1 ,   , PhD, CPsychol 2
      European Journal of Cancer Care
      John Wiley and Sons Inc.
      breast, cancer, pain, patient satisfaction, radiography

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          Abstract

          Mammography can be painful and unpleasant, but effective interventions to improve the experience remain scarce. As a first step towards more effective interventions, we aimed to achieve a thorough, contemporary understanding of thoughts, feelings and behaviours which affect and arise from mammography experiences. Research and professional experience suggest that the interaction between client and practitioner may be paramount in determining the quality of a client's experience. Therefore, this study aimed to capture the perspectives of clients and mammography staff from UK breast screening programmes. Thematic analysis of semi‐structured qualitative in‐depth interviews with 22 clients and 18 staff revealed that clients had positive attitudes to breast screening and mostly low knowledge about potential harms. Staff data indicated that some women attend for breast screening under pressure from others. Pain and coping with it were prominent themes, with wide variations in pain experiences. Clients recognised differences in mammographers’ abilities to put them at ease. Staff difficulties included empowering clients within the confines of a taxing technique, and maintaining compassionate care when under strain. Future intervention development should focus on the information and support needs of women prior to the appointment and on effectively training and supporting mammographers to deal with challenging encounters.

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          Most cited references33

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          The efficacy of empathy training: A meta-analysis of randomized controlled trials.

          [Correction Notice: An Erratum for this article was reported in Vol 63(1) of Journal of Counseling Psychology (see record 2015-58774-003). In the article, the last name of author Emily Teding van Berkhout was incorrectly set in the running head as van Berkhout. It should be Teding van Berkhout. All versions of this article have been corrected.] High levels of empathy are associated with healthy relationships and prosocial behavior; in health professionals, high levels of empathy are associated with better therapeutic outcomes. To determine whether empathy can be taught, researchers have evaluated empathy training programs. After excluding 1 outlier study that showed a very large effect with few participants, the meta-analysis included 18 randomized controlled trials of empathy training with a total of 1,018 participants. The findings suggest that empathy training programs are effective overall, with a medium effect (g = 0.63), adjusted to 0.51 after trim-and-fill evaluation for estimated publication bias. Moderator analyses indicated that 4 factors were statistically significantly associated with higher effect sizes: (a) training health professionals and university students rather than other types of individuals, (b) compensating trainees for their participation, (c) using empathy measures that focus exclusively on assessing understanding the emotions of others, feeling those emotions, or commenting accurately on the emotions, and (d) using objective measures rather than self-report measures. Number of hours of training and time between preintervention assessment and postintervention assessment were not statistically significantly associated with effect size, with 6 months the longest time period for assessment. The findings indicate that (a) empathy training tends to be effective and (b) experimental research is warranted on the impact of different types of trainees, training conditions, and types of assessment. (PsycINFO Database Record
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            Patient perspectives on information and choice in cancer screening: a qualitative study in the UK.

            The principle of informed choice has been recently incorporated into cancer screening policy. However, there is limited empirical or theoretical work on informed choice in this particular context. The main aim of the study reported here was to explore the information needs of people invited for screening, and to gain insights into the relationship between the information they wanted and the choices they made. A qualitative study (nine focus groups and 15 individual interviews) was undertaken with people who had contrasting experiences (and outcomes) of either breast, cervical, or colorectal cancer screening at two locations in Scotland, UK. Findings suggest that lay people define and conceptualise informed choice differently from policy makers. The study also found that information about the disease was as important to people as information on the risks and limitations of screening. However, information may have little part to play in the choices people make. Rather, it may have more impact on outcomes such as satisfaction and anxiety. An explicit policy aim in promoting informed choice is to enhance patient autonomy and to prevent people from being deceived or coerced. However, this research shows that the provision of evidence-based information alone does not necessarily mean that an informed choice is made. People may not read, want, or understand the information, and, additionally, they may not be able to carry out their intended choice. There may be personal barriers, such as physical or mental health problems and language, or organisational barriers, such as the availability of the service/intervention and access. Therefore, the term 'informed choice' might not be useful in this context.
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              Responding empathically to patients: Development, implementation, and evaluation of a communication skills training module for oncology nurses.

              The purpose of this paper is to report on the development, implementation, and evaluation of a Communication Skills Training (CST) module for inpatient oncology nurses on how to respond empathically to patients.
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                Author and article information

                Contributors
                Role: Senior Research Radiographerp.j.whelehan@dundee.ac.uk
                Role: Professor of Breast Imaging
                Role: Senior Lecturer in Health Psychology
                Journal
                Eur J Cancer Care (Engl)
                Eur J Cancer Care (Engl)
                10.1111/(ISSN)1365-2354
                ECC
                European Journal of Cancer Care
                John Wiley and Sons Inc. (Hoboken )
                0961-5423
                1365-2354
                13 October 2016
                May 2017
                : 26
                : 3 , Themed section: Primary care and cancer control ( doiID: 10.1111/ecc.2017.26.issue-3 )
                : e12580
                Affiliations
                [ 1 ] School of MedicineUniversity of Dundee Mailbox 4 Ninewells Hospital & Medical School DundeeUK
                [ 2 ] School of MedicineUniversity of St Andrews St AndrewsUK
                Author notes
                [*] [* ] Correspondence

                Patsy Whelehan, School of Medicine, University of Dundee, Mailbox 4, Ninewells Hospital & Medical School, Dundee, DD1 9SY, UK.

                Email: p.j.whelehan@ 123456dundee.ac.uk

                Article
                ECC12580
                10.1111/ecc.12580
                5484333
                27739138
                8691a3ae-c324-4376-81ae-00a6be037aee
                © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 26 August 2016
                Page count
                Figures: 1, Tables: 2, Pages: 13, Words: 9517
                Funding
                Funded by: College of Radiographers Industrial Partnership Scheme
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                ecc12580
                May 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.2 mode:remove_FC converted:26.06.2017

                Oncology & Radiotherapy
                breast,cancer,pain,patient satisfaction,radiography
                Oncology & Radiotherapy
                breast, cancer, pain, patient satisfaction, radiography

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