Patients with cancer seem to experience distress particularly in the first period after diagnosis, and are likely to develop an affective disorder in the first 2 to 3 months. Communicative behaviors of nurses seem to play an important role in meeting the cognitive and affective needs of patients with cancer. This review of the literature examines the communicative behaviors of nurses during care activities with patients who have cancer. The studies show that emphasis is placed on the affective side, in which facilitating behaviors such as empathy, touch, comforting, and supporting are considered essential in caring for patients with cancer. Unfortunately, further studies in this review demonstrate that communication in oncologic care is complicated by such emotionally laden issues as the consequences associated with the life-threatening character of the disease and the far-reaching consequences of the medical treatment. This results in barriers to effective communication between patients with cancer and nurses. It is important, therefore, that nurses working with patients who have cancer are provided both structurally and repeatedly with continuing education programs in communication. Finally, most of the studies covered in this review have an explorative character. Future research in this area should pay attention to the use of controlled studies, large sample sizes, and observational instruments.
Irma P. M. Kruijver is a Research Fellow, The Netherlands Institute of Primary Health Care (NIVEL), Utrecht.
Ada Kerkstra is a Coordinator, Department of Nursing and Caring Research, The Netherlands Institute of Primary Health Care (NIVEL), Utrecht.
Jozien M. Bensing is Director, The Netherlands Institute of Primary Health Care (NIVEL), Utrecht, and Professor, Department of Clinical and Health Psychology, University of Utrecht.
Harry B. M. van de Wiel is Professor, Department of Medical Psychology, Academic Hospital, Groningen, The Netherlands.
Address correspondence and reprint request to I. P. M. Kruijver, The Netherlands Institute of Primary Health Care (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands.
Accepted for publication on May 26, 1999.