Communication in cancer: its impact on the experience of cancer care: communicating with the angry patient and the patient in denial

Purpose of review This review aims to describe the recent literature on communication between cancer care clinicians and angry patients and patients in denial. Recent findings Clinicians had improved perceived self-efficacy in responding to patient anger after completing anger management training, with a focus on reframing anger as a normative response to unmet needs. Psychosocial and mindfulness programmes for cancer patients were found to be useful for modifying anger response to stressors. Existing clinician communication guidelines may not meet the complex needs of adolescents and individuals with anger-prone personality expressing anger. The detrimental effects of avoiding communication about cancer and dying in patients and families include increased stress and emotional burden, patient depression and anxiety and regret in bereaved family members. Further understanding of the complex interplay between the expression of instrumental and emotional concerns of patients may lead to improved clinician communication. Summary Anger and maladaptive denial in patients with cancer have detrimental effects that can be seen across a wide range of cultural contexts, in not only the patient but also in their families and the involved clinicians. Training interventions for both patients and clinicians can benefit patient emotional response and perceived clinician self-efficacy. Correspondence to Christopher Tino Hamana Pene, MBChB, FRACP, FAChPM, Sacred Heart Health Service, 170 Darlinghurst Road, Darlinghurst, NSW 2010, Australia. Tel: +61 4 83829444; e-mail: Christopher.pene@svha.org.au Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://bit.ly/2GBaeUr). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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