BACKGROUND Early integration of palliative care concurrently to standard cancer care is associated with several benefits for patients and their caregivers. However, communication barriers on part of the caring physicians often impede a timely referral to palliative care. This study describes the protocol of the evaluation of a communication skills training aiming to strengthen the ability of physicians to address palliative care related topics adequately and early during disease trajectory. METHODS We will implement a communication skills training and evaluate it within a prospective, multi-centered, two-armed randomized controlled trial (RCT), which will be conducted at four sites in Germany. Eligible subjects are all physicians treating patients with advanced cancer in their daily routine. An intervention group (IG) receiving a group training will be compared to a wait-list control group (CG) receiving the training after completion of data collection. At pre- and post-measurement points, participants will conduct videotaped conversations with standardized simulated patients (SP). Primary outcome will be the external rating of communication skills and consulting competencies addressing palliative care related topics. Secondary outcomes on core concepts of palliative care, basic knowledge, attitudes, confidence and self-efficacy will be assessed by standardized questionnaires and self-developed items. A further external assessment of the quality of physician-patient-interaction will be conducted by the SP. Longitudinal quantitative data will be analyzed using covariate-adjusted linear mixed-models. DISCUSSION If the communication skills training proves to be effective, it will provide a feasible intervention to promote an earlier communication of palliative care related topics in the care of advanced cancer patients. This would help to further establish early integration of palliative care as it is recommended by national and international guidelines. TRIAL REGISTRATION German Clinical Trials Register DRKS00017025 (date of registration: 4 June 2019).

中文翻译：

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评估交流技能培训以促进解决晚期癌症患者姑息治疗相关主题的评估：一项多中心随机对照试验（PALLI-KOM）的研究方案。

背景技术姑息治疗与标准癌症治疗的早期整合与患者及其护理者的若干益处有关。但是，部分有爱心的医生的沟通障碍经常阻碍及时转诊至姑息治疗。这项研究描述了一项沟通技能培训评估的协议，旨在增强医师在疾病轨迹期间及早充分解决姑息治疗相关主题的能力。方法我们将进行沟通技巧培训，并在一项前瞻性，多中心，两臂的随机对照试验（RCT）中进行评估，该试验将在德国的四个地点进行。符合条件的受试者是所有在日常生活中治疗晚期癌症患者的医生。在完成数据收集之后，将接受小组培训的干预组（IG）与接受培训的候补对照组（CG）进行比较。在测量前和测量后，参与者将与标准化模拟患者（SP）进行录像对话。主要结果将是针对姑息治疗相关主题的沟通技能和咨询能力的外部评级。姑息治疗核心概念，基本知识，态度，信心和自我效能的次要结果将通过标准化问卷和自行开发的项目进行评估。SP将对医患互动进行进一步的外部评估。纵向定量数据将使用协变量调整后的线性混合模型进行分析。讨论如果交流技巧培训被证明是有效的，它将为晚期癌症患者的护理中促进姑息治疗相关主题的早期交流提供可行的干预措施。根据国家和国际准则的建议，这将有助于进一步建立姑息治疗的早期整合。试用注册德国临床试验注册DRKS00017025（注册日期：2019年6月4日）。