Patient-centered Communication and Prognosis Discussions with Cancer Patients

Overview

Journal Patient Educ Couns

Publisher Elsevier

Specialties Health Services
Nursing

Date 2009 Oct 13

PMID 19819098

Citations 19

Authors

Cleveland G Shields

Casey J Coker

Shruti S Poulsen

Jennifer M Doyle

Kevin Fiscella

Ronald M Epstein

Jennifer J Griggs

Affiliations

Soon will be listed here.

Abstract

Objective: To examine physician communication associated with prognosis discussion with cancer patients.

Methods: We conducted a study of physician-patient communication using trained actors. Thirty-nine physicians, including 19 oncologists and 20 family physicians participated in the study. Actors carried two hidden digital recorders to unannounced visits. We coded recordings for eliciting and validating patient concerns, attentive voice tone, and prognosis talk.

Results: Actor adherence to role averaged 92% and the suspected detection rate was 14%. In a multiple regression, eliciting and validating patient concerns (beta=.40, C.I.=0.11-0.68) attentiveness (beta=.32, C.I.=0.06-0.58) and being an oncologist vs. a family physician (beta=.33, C.I.=0.33-1.36) accounted for 46% of the variance in prognosis communication.

Conclusion: Eliciting and validating patient concerns and attentiveness voice tone is associated with increased discussion of cancer patient prognosis as is physician specialty.

Practice Implications: Eliciting and validating patient concerns and attentive voice tone may be markers of physician willingness to discuss emotionally difficult topics. Educating physicians about mindful practice may increase their ability to collect important information and to attend to patient concerns.

Citing Articles

Examining how physician factors influence patient satisfaction during clinical consultations about cancer prognosis and pain.

Lou Z, Vivas-Valencia C, Shields C, Kong N PEC Innov. 2023; 1:100017.

PMID: 37213781 PMC: 10194410. DOI: 10.1016/j.pecinn.2022.100017.

Patient activation reduces effects of implicit bias on doctor-patient interactions.

Gainsburg I, Derricks V, Shields C, Fiscella K, Epstein R, Yu V Proc Natl Acad Sci U S A. 2022; 119(32):e2203915119.

PMID: 35914161 PMC: 9371681. DOI: 10.1073/pnas.2203915119.

Is physician implicit bias associated with differences in care by patient race for metastatic cancer-related pain?.

Fiscella K, Epstein R, Griggs J, Marshall M, Shields C PLoS One. 2021; 16(10):e0257794.

PMID: 34705826 PMC: 8550362. DOI: 10.1371/journal.pone.0257794.

Surgeon Strategies to Patient-Centered Decision-making in Cancer Care: Validation and Applications of a Conceptual Model.

Kelly E, Myers B, McGee J, Hyer M, Tsilimigras D, Pawlik T J Cancer Educ. 2021; 37(6):1719-1726.

PMID: 33942256 DOI: 10.1007/s13187-021-02017-y.

Social networks of older patients with advanced cancer: Potential contributions of an integrated mixed methods network analysis.

Yousefi Nooraie R, Mohile S, Yilmaz S, Bauer J, Epstein R J Geriatr Oncol. 2020; 12(5):855-859.

PMID: 33342721 PMC: 8184572. DOI: 10.1016/j.jgo.2020.12.005.

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