Effectiveness of Japanese SHARE model in improving Taiwanese healthcare personnel's preference for cancer truth telling

Background: Communication skills training (CST) based on the Japanese SHARE model of family-centered truth telling in Asian countries has been adopted in Taiwan. However, its effectiveness in Taiwan has only been preliminarily verified. This study aimed to test the effect of SHARE model-centered CST on Taiwanese healthcare providers' truth-telling preference, to determine the effect size, and to compare the effect of 1-day and 2-day CST programs on participants' truth-telling preference.

Method: For this one-group, pretest-posttest study, 10 CST programs were conducted from August 2010 to November 2011 under certified facilitators and with standard patients. Participants (257 healthcare personnel from northern, central, southern, and eastern Taiwan) chose the 1-day (n = 94) or 2-day (n = 163) CST program as convenient. Participants' self-reported truth-telling preference was measured before and immediately after CST programs, with CST program assessment afterward.

Results: The CST programs significantly improved healthcare personnel's truth-telling preference (mean pretest and posttest scores ± standard deviation (SD): 263.8 ± 27.0 vs. 281.8 ± 22.9, p < 0.001). The CST programs effected a significant, large (d = 0.91) improvement in overall truth-telling preference and significantly improved method of disclosure, emotional support, and additional information (p < 0.001). Participation in 1-day or 2-day CST programs did not significantly affect participants' truth-telling preference (p > 0.05) except for the setting subscale. Most participants were satisfied with the CST programs (93.8%) and were willing to recommend them to colleagues (98.5%).

Conclusions: The SHARE model-centered CST programs significantly improved Taiwanese healthcare personnel's truth-telling preference. Future studies should objectively assess participants' truth-telling preference, for example, by cancer patients, their families, and other medical team personnel and at longer times after CST programs.