Listening with Care

Tom Hack [MA/91, PhD/95] received one of the highest honours awarded by Canada’s academic community when he was inducted in September as a fellow of the Canadian Academy of Health Sciences.

The professor of nursing has significantly advanced our understanding of the psychosocial experiences of people with cancer.

His notable research includes a series of studies showing the benefits of providing cancer patients with audio recordings of oncology consultations.

“Re-listening to appointments can reduce patients’ anxiety, improve their recall of information and help in communication with family members or caregivers,” Hack says.

These findings have translated into real-world impact. Patients at CancerCare Manitoba can now have their consultations recorded, and in Alberta, all newly diagnosed cancer patients receive a smartphone app to record conversations with their cancer care team.

Hack, who grew up in Saskatoon, initially earned a degree in commerce from the University of Saskatchewan. But after working for a year at a management consulting firm, he switched gears and pursued his interest in clinical psychology.

He had started wondering as a teenager how people cope with lifethreatening illness and the possibility of dying.

“I think it all came from my mom talking about her mother having had breast cancer in the 1930s,” he says. “My mom was shocked by the effects of harsh radiation treatments on my grandmother’s body – a grandmother whom I would never meet because of cancer.”

Hack earned a bachelor of science from the University of Calgary and a master’s and PhD from the U of M. He completed his clinical psychology internship at Harvard Medical School.

Many of his research studies have involved interviewing patients with cancer, then applying scientific rigour to analyzing and coding their responses. “The goal is to gain measurable insight into how people cope with the disease and what their non-physical needs are, so we can minimize patients’ distress and enhance their well-being,” he says.

Hack’s research has found, for example, that patients who respond to their cancer diagnosis with cognitive avoidance have poor short- and long-term psychological adjustment; that women are psychologically affected by swollen, painful arms following breast cancer surgery; and that dying patients describe life as meaningful only when it’s lived in fulfilment of personal values, such as family, true friendship or a sense of accomplishment.

Hack’s involvement with the College of Nursing started during his master’s studies, when Dr. Lesley Degner, now a distinguished professor emeritus, approached him to write an annotated bibliography on communication between cancer patients and health-care providers. “She’s a gifted mentor and I owe her my career,” he says about Degner.

Hack joined the College of Nursing faculty in 2000. For the next 13 years he also worked as a clinical psychologist at CancerCare Manitoba.

His work became more research-focused as he took on other appointments, such as director of psychosocial oncology and cancer nursing research at St. Boniface Hospital’s I.H. Asper Clinical Research Institute. Since 2013, he has been a visiting professor at England’s University of Central Lancashire.

“It was hard for me to leave the clinical position,” Hack says. “Providing supportive counselling to cancer patients and their families made me feel that I was serving society in a meaningful way. And my research would not have been as successful if it hadn’t been informed by my clinical work.”

Hack recently received the Lifetime Achievement Award from the Canadian Association of Psychosocial Oncology. He is currently working with Dr. Shane Sinclair of the University of Calgary, with whom he has created a compassion questionnaire based on the perspectives of patients with life-limiting illness and professionals who treat them.

“We’re very proud that we’ve developed the first patient-driven model of compassion and an empirically sound tool for measuring compassion,” he says. “One thing we’ve learned by listening to patients is that compassion is a virtuous response that can be taught.”