ABSTRACT There is an increasing awareness that effective communication skills of health care professionals (HCP) are needed to achieve desired health outcomes. Consequently, there has been a growing demand for effective methods to assess communication skills and communication skills training programs. A software –for the French language– has been developed for these purposes. This software is called “LaComm” (Logiciel d’Analyse de la Communication). The aim of this software is to analyse the verbal communication. This software identifies communication skills used by professionals as well as their effects on patients and relatives utterances. LaComm analyses utterances transcripted from audiotaped interviews. LaComm was developed to assess HCP communication skills (by an heuristic method) and to assess topics discussed in HCP-patient interviews (by a topics analysis method).
Preserving the best possible quality of life for cancer patients and their families has become a major goal in cancer care. However, the cumulative effects of stressors related to cancer care, many of which involve communicating with patients and relatives, may lead to the development of health care professionals burnout and poor quality of care. Many health care professionals lack the psychosocial knowledge and communications skills needed to identify patients’concerns and problems. Teaching strategies are therefore being developped to improve health care professionals’communication skills. Available tools for analysing two persons interviews require highly trained psychologist to achieve inter-rater reliability. Theses scoring systems are also time consuming. Moreover, none of available tools allows the analysis of three persons interviews. More empirically, it has been shown in a randomised design that nurses which participate to a communication skills training program increased use of emotional words in their interactions with patients (Razavi et al, 2002). For all these reasons, a software designed specifically for assessing health care professionals communication skills was considered as needed and therefore developed. This software –developed for the French language– is called “LaComm” (Logiciel d’analyse de la Communication).
METHODS LaComm is constructed on the basis of an empirical approach referring to various linguistic models. Each utterance is as a “chain of Markov” (1913), which respects the rules of grammar (Transformational Generative Grammar formalized by the Augmented Transition Network Grammar) (Chomsky, 1957, 1965; Woods, 1970). It should be recalled also that each utterance which is analysed by the Lacomm appears in the context of very specific speech situations (communication in medicine in general and oncology in particular) (Austin, 1962; Searle, 1969). For these reasons, each utterance may be tagged by the LaComm with relatively small databases of “preset categories of communication skills”. The “preset categories of communication skills” were adapted from the categories of CRCWEM (Booth, 1991) and were redefined by a panel of experts. LaComm uses databases of «preset categories of communication skills» built on pragmatical knowledges related to health care professionals clinical practice, on psycho-oncological knowledges, on emotional literature knowledges, on dictionary derived knowledges, and on empirical knowledges derived from actual and simulated interviews performed by physicians. LaComm has greatly benefited from databases of an empirical study (Razavi et al., 2003, Delvaux et al., 2005,). To generate each database of “preset categories of communication skills”, canonical utterances were extracted and widened by using dictionaries of synonyms. All canonical utterances were validated by a panel of experts. To analyse each utterance, LaComm uses a heuristic method of matching at two level. The first level can be described as follow: each utterance is examined by all “preset categories of communication skills” databases until matching. The second level can be described as follow: each category is defined by a strict combination of databases stored utterances. LaComm may provide also another type of content analysis: each utterance is examined by all words or expressions databases of various topics (psychological, medical and others). LaComm calculate the number of utterances tagged by each “preset categories of communication skills” and by each topics databases. Lacomm is written in Visual Basic 6 and use Microsoft.Jet.OLEDB.4.0 to link to ACCESS 2000.
DEVELOMENT OF PRESET CATEGORIES OF COMMUNICATION SKILLS DATABASES
1. Assessment skills and «preset categories
of assessment skills» databases.
1.1. Open assessment skills and «preset
categories of open assessment skills» databases.
1.2. Half-open assessment skills and «preset
categories of half-open assessment skills» databases.
1.3. Closed assessment skills and «preset
categories of closed assessment skills» databases.
1.4. Checking skills and «preset categories
of checking skills» databases