• Lena Heyn, Cornelia M Ruland, and Arnstein Finset.
• Center for Shared Decision Making and Nursing Research, Oslo University Hospital, Rikshospitalet, Oslo, Norway. lena.heyn@rr-research.no
• Patient Educ Couns. 2012 Feb 1; 86 (2): 158-65.

ObjectiveTo test the effect of Choice, an interactive tailored patient assessment tool (ITPA), on cancer patients' expressed cues and concerns (C&Cs), and clinicians' responses to these C&Cs.Methods97 experimental group consultations, where patients used the Choice ITPA to report their symptoms and problems in preparation to their consultation, were compared to 99 control group consultations. All consultations were audio-taped and coded using the Verona Coding Definitions of Emotional Sequences (VR-CoDES).ResultsWe identified 473 cues and 109 concerns with a mean number of 3.0 (SD=3.2). The most frequent utterance was cue B (45.2%), indicating expression of uncertainty or hope. We found more C&Cs in consultations with the Choice ITPA compared to the control group (p<0.01), and in consultations with nurses compared to physicians (p<0.001). No differences in clinicians' response types in the two groups were found. However, significant differences in response type between nurses and physicians were found.ConclusionThe Choice ITPA was an effective tool to disclose cancer patients' cues and concerns.Practice ImplicationsThe Choice ITPA proved to be an effective intervention for cancer patients to express more C&Cs, but should be accompanied with communication skills training to potentially produce more patient-centered responses from the clinicians. (ClinicalTrials.gov number NCT00857103.)Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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