What Patients Value When Oncologists Give News of Cancer Recurrence: Commentary on Specific Moments in Audio-Recorded Conversations
- 24 February 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in The Oncologist
- Vol. 16 (3), 342-350
- https://doi.org/10.1634/theoncologist.2010-0274
Abstract
Learning Objectives: After completing this course, the reader will be able to: Incorporate the three themes identified in this study to refine discussion with patients of their cancer recurrence.Manage discussion with patients of cancer recurrence with recognition of the impact of the news on the patient and guidance as to next steps. This article is available for continuing medical education credit at CME.TheOncologist.com Purpose.: Recommendations for communicating bad or serious news are based on limited evidence. This study was designed to understand patient perspectives on what patients value when oncologists communicate news of cancer recurrence. Study Design and Methods.: Participants were 23 patients treated for a gastrointestinal cancer at a tertiary U.S. cancer center within the past 2 years, who had semistructured qualitative interviews in which they listened to audio recordings of an oncology fellow discussing news of cancer recurrence with a standardized patient. Participants paused the audio recording to comment on what they liked or disliked about the oncologist's communication. Results.: Three themes were identified that refine existing approaches to discussing serious news. The first theme, recognition, described how the oncologist responded to the gravity of the news of cancer recurrence for the patient. Participants saw the need for recognition throughout the encounter and not just after the news was given. The second theme, guiding, describes what participants wanted after hearing the news, which was for the oncologist to draw on her biomedical expertise to frame the news and plan next steps. The third theme, responsiveness, referred to the oncologist's ability to sense the need for recognition or guidance and to move fluidly between them. Conclusion.: This study suggests that oncologists giving news of cancer recurrence could think of the communication as going back and forth between recognition and guidance and could ask themselves: “Have I demonstrated that I recognize the patient's experience hearing the news?” and “Have I provided guidance to the next steps?”Keywords
Funding Information
- Lance Armstrong Foundation
This publication has 26 references indexed in Scilit:
- Disclosing a Diagnosis of Cancer: Where and How Does It Occur?Journal of Clinical Oncology, 2010
- Pessimism Is No PoisonJournal of Clinical Oncology, 2010
- Compassionate Silence in the Patient–Clinician Encounter: A Contemplative ApproachJournal of Palliative Medicine, 2009
- An examination of the initial cancer consultation of medical and radiation oncologists using the Cancode interaction analysis systemBritish Journal of Cancer, 2008
- Breaking Bad News: More Than Just GuidelinesJournal of Clinical Oncology, 2006
- Editorial: Towards a communicative mentality in medical and healthcare practiceCommunication & Medicine, 2004
- Doctors' communication of trust, care, and respect in breast cancer: qualitative studyBMJ, 2004
- Qualitative research in health care: Assessing quality in qualitative researchBMJ, 2000
- Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and PatientPublished by American Medical Association (AMA) ,1997
- Sample size in qualitative researchResearch in Nursing & Health, 1995