Baseline characteristics of oncology physicians and study flow
breast cancer, CIM, cancer, SD, gynecological cancers, CIMReasons, tumors
GASTROINTESTINAL TUMORS, REGRESSION, BREAST CANCER, CANCER, ONCOLOGY, TUMORS
A total of 47 oncology physicians (All the oncology physicians were asked to conduct up to 10 KOKON-KTO conversations each with their cancer patients and to provide the KOKON-KTO information leaflet (intervention group) or only provide the leaflet to patients (control group); then, the physicians were asked to complete a questionnaire after each consultation/provision of the KOKON-KTO information leaflet (tThe demographic characteristics of the participating oncology physicians are presented in Table Oncology physicians’ characteristicsOf the 297 included patients, 84.2% were female and 55.0 years old on average (intervention: 54.1 ± 10.6; control: 55.6 ± 11.8). The graduation level of 120 patients was A-Level or higher (intervention: 49 (30.4%) vs. control: 71 (42.0%)). Fifty-six percent of patients were diagnosed with breast cancer (intervention: 60.9% vs. control: 52.1%) and 9.8% with other gynecological cancers (intervention: 7.8% vs. control: 11.2%). Oncology physicians in the control group treated patients with more severe tumors, such as gastrointestinal tumors (intervention: 10.2% vs. control: 15.4%) and pulmonological tumors (intervention: 3.9% vs. control: 7.1%). The treatment objective of 62.3% of patients (intervention: 68.8% vs. control: 57.4%) was curative/adjuvant, for 34.3% it was palliative (intervention: 26.6% vs. control: 40.2%), and for 3.4% (intervention: 5.7% vs. control: 2.3%) it was not clear.a) Physician level.In regard to the anticipated effectiveness of specific CIM therapies, physical activity during anti-tumor therapy was concordantly rated as effective among most intervention oncology physicians, followed by acupuncture (95.2% agreement). More oncology physicians rated mistletoe, ginseng, and acupuncture as effective following e-learning, whereas a substantial decrease was found for the rated effectiveness of curcuma. Mindfulness training and acupuncture were considered safe CIM therapies by most oncology physicians after the training. The percentage of participants who considered hypnosis, mistletoe, and acupuncture safe increased, and the percentage of participants who considered physical activity safe decreased. The results of both time points are presented in Table Oncology physicians’ ratings of their anticipated CIM effectiveness (in %) and CIM safety
The duration of consultations in the intervention group was 22.6 min on average (SD = 4.7). The oncology physicians in the control group communicated with their cancer patients for an average of 7.1 min (SD = 4.2).Regarding the perceived stress reaction, oncology physicians in the intervention group scored lower than those in the control group on all five items. There was no significant difference between oncology physicians in the intervention and control group regarding perceived consultation skill competency. However, the mean scores were lower for all three levels of consultation skills (overburden: intervention 1.4 (95% CI: 0.7;2.1), control 2.1 (95% CI: 1.4;2.7); tension: intervention 1.3 (95% CI: 0.7;2.0), control 1.9 (1.3;2.5); and discomfort with the consultation situation: intervention 1.0 (95% CI: 0.4;1.7), control 1.7 (95% CI 1.2;2.3)) (Table Primary outcomes at the physician level in the intention-to-treat sample. Linear Mixed Model analyses (adjusted means and differences between the intervention and control group)The results of the sensitivity analyses were comparable to those utilizing the intention-to-treat sample.There was no statistically significant difference in the rating of the ability of the consultation to be implemented between the two groups, with only small differences between the groups (intervention: 5.0 (95% CI: 4.8; 5.3), control 5.2 (95% CI: 5.0;5.5)).Regarding the attitudes of oncology physicians toward CIM, the intervention group scored statistically significantly higher in being confident in conducting conversations, and statistically significantly lower in trying to avoid CIM conversations (Table Results of linear regression analyses on attitudes toward CIMReasons stated by participating oncology physicians in the intervention group for conducting a KOKON-KTO consultation longer than 20 min included motivating the patient to change a behavior and having an overall more detailed consultation.b) Patient level.Of the 275 participating patients, the vast majority of both groups read the information leaflet about recommended CIM websites (intervention: 63.9%; control: 73.2%), and 68% of patients reported using at least one of the recommended websites. A smaller group (intervention: 20.5%; control: 15.7%) did not read the information leaflet before completing the questionnaire but were planning to do so in the future.c) Physician–patient interaction.The oncology physicians who participated in the workshop were able to demonstrate interactive and communicative competencies that are necessary for good physician–patient interactions (see table in the supplemental materials). In an earlier publication was reported that oncology physicians in the intervention group were able to apply the skills they had learned during the KOKON-KTO training after the workshop [