• Smita C Banerjee, Noshin Haque, Elizabeth A Schofield, Timothy J Williamson, Chloe M Martin, Carma L Bylund, Megan J Shen, Maureen Rigney, Heidi A Hamann, Patricia A Parker, Daniel C McFarland, Bernard J Park, Daniela Molena, Aimee Moreno, and Jamie S Ostroff.
• From the Department of Psychiatry and Behavioral Sciences (S. C. Banerjee, N. Haque, E. A. Schofield, T. J. Williamson, C. M. Martin, P. A. Parker, D. C. McFarland, A. Moreno, J. S. Ostroff), Memorial Sloan Kettering Cancer Center, New York, NY; Department of Public Relations (C. L. Bylund), Division of Hematology & Oncology, College of Medicine, University of Florida, Gainesville, FL; Department of Medicine (M. J. Shen), Weill Cornell Medical College, New York, NY; Support Initiatives, GO2 Foundation for Lung Cancer (M. Rigney), Washington, DC; Department of Psychology and the Department of Family and Community Medicine (H. A. Hamann), University of Arizona, Tucson, AZ; and Department of Surgery (B. J. Park, D. Molena), Memorial Sloan Kettering Cancer Center, New York, NY.. Electronic address: banerjes@mskcc.org.
• Chest. 2021 May 1; 159 (5): 204020492040-2049.

BackgroundDespite the clinical importance of assessing smoking history and advising patients who smoke to quit, patients with lung cancer often experience feelings of blame and stigma during clinical encounters with their oncology care providers (OCPs). Promoting empathic communication during these encounters may help reduce patients' experience of stigma and improve related clinical outcomes. This paper presents the evaluation of OCP- and patient-reported data on the usefulness of an OCP-targeted empathic communication skills (ECS) training to reduce the stigma of lung cancer and improve communication.Research QuestionWhat is the impact of the ECS intervention on OCPs' communication skills uptake and patient-reported outcomes (lung cancer stigma, satisfaction with communication, and perceived OCP empathy)?MethodsStudy subjects included 30 multidisciplinary OCPs treating patients with lung cancer who participated in a 2.25 h ECS training. Standardized Patient Assessments were conducted prior to and following training to assess ECS uptake among OCPs. In addition, of a planned 180 patients who currently or formerly smoked (six unique patients per OCP [three pretraining, three posttraining]), 175 patients (89 pretraining, 86 posttraining) completed post-OCP visit surveys eliciting feedback on the quality of their interaction with their OCP.ResultsOCPs exhibited an overall increase in use of empathic communication skills [t(28) = -2.37; P < .05], stigma-mitigating skills [t(28) = -3.88; P < .001], and breadth of communication skill use [t(28) = -2.91; P < .01]. Patients reported significantly higher overall satisfaction with communication post-ECS training, compared with pretraining [t(121) = 2.15; P = .034; Cohen d = 0.35]. There were no significant differences from pretraining to posttraining for patient-reported stigma or perceived OCP empathy.InterpretationEmpathy-based, stigma-reducing communication may lead to improved assessments of tobacco use and smoking cessation for patients with smoking-related cancers. These findings support the dissemination and further testing of a new ECS model for training OCPs in best practices for assessment of smoking history and engagement of patients who currently smoke in tobacco treatment delivery.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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