Burden on Oncologists when Communicating the Discontinuation of Anticancer Treatment

Overview

Journal Jpn J Clin Oncol

Publisher Oxford University Press

Specialty Oncology

Date 2011 Jul 19

PMID 21764830

Citations 17

Authors

Hiroyuki Otani

Tatsuya Morita

Taito Esaki

Hiroshi Ariyama

Koichiro Tsukasa

Akira Oshima

Keiko Shiraisi

Affiliations

Soon will be listed here.

Abstract

Objective: Communicating the discontinuation of anticancer treatment to patients is a difficult task. The primary aim of this study was to clarify the level of oncologist-reported burden when communicating about discontinuation of an anticancer treatment. The secondary aims were (i) to identify the sources of burden contributing to their levels and (ii) to explore the useful strategies to alleviate their burden.

Methods: A multicenter nationwide questionnaire survey was conducted on 620 oncologists across Japan (response rate, 67%).

Results: High levels of perceived burden were reported by 47% of respondents, and 17% reported that they sometimes, often or always wanted to stop oncology work because of this burden. There was a significant association between high levels of burden and: a feeling that breaking bad news would deprive the patient of hope; concern that the patient's family would blame the oncologist; concern that the patient may lose self-control; and a feeling that there was not enough time to break the bad news. Strategies perceived to be useful by oncologists included training in how to effectively communicate to patients discontinuation of anticancer treatment, a reduction in total workload to allow sufficient time to break bad news, and development of a multidisciplinary model to facilitate cooperation with other professionals and facilities.

Conclusions: Many oncologists reported high levels of burden relating to communication of discontinuation of anticancer treatment. A specific communication skills training program, sufficient time for communication and development of a multidisciplinary model could help alleviate the burden on oncologists.

Citing Articles

A Joanna Briggs Institute Framework Approach to Shared Decision Making in End-of-Life.

Glaria M, Fernandez M, Salgado C, Hernandez-Leal M Health Expect. 2024; 27(5):e70041.

PMID: 39373127 PMC: 11456961. DOI: 10.1111/hex.70041.

Preferences of bereaved family members on communication with physicians when discontinuing anticancer treatment: referring to the concept of nudges.

Yoshida S, Hirai K, Ohtake F, Masukawa K, Morita T, Kizawa Y Jpn J Clin Oncol. 2024; 54(7):787-796.

PMID: 38553776 PMC: 11228860. DOI: 10.1093/jjco/hyae038.

The trajectory of prognostic cognition in patients with advanced cancer: is the traditional advance care planning approach desirable for patients?.

Hasegawa T, Okuyama T, Akechi T Jpn J Clin Oncol. 2024; 54(5):507-515.

PMID: 38336476 PMC: 11075734. DOI: 10.1093/jjco/hyae006.

How to break bad news and how to learn this skill: results from an international North-Eastern German Society for Gynecological Oncology (NOGGO) survey among physicians and medical students with 1089 participants.

Herzog E, Pirmorady Sehouli A, Boer J, Pietzner K, Petru E, Heinzelmann V Int J Gynecol Cancer. 2023; 33(12):1934-1942.

PMID: 38052472 PMC: 10804030. DOI: 10.1136/ijgc-2023-004693.

Physicians' attitudes and experiences about withholding/withdrawing life-sustaining treatments in pediatrics: a systematic review of quantitative evidence.

Zhong Y, Cavolo A, Labarque V, Gastmans C BMC Palliat Care. 2023; 22(1):145.

PMID: 37773128 PMC: 10540364. DOI: 10.1186/s12904-023-01260-y.

References

Walling A, Lorenz K, Dy S, Naeim A, Sanati H, Asch S . Evidence-based recommendations for information and care planning in cancer care. J Clin Oncol. 2008; 26(23):3896-902. DOI: 10.1200/JCO.2007.15.9509. View

Jenkins V, Fallowfield L . Can communication skills training alter physicians' beliefs and behavior in clinics?. J Clin Oncol. 2002; 20(3):765-9. DOI: 10.1200/JCO.2002.20.3.765. View

Zwarenstein M, Goldman J, Reeves S . Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2009; (3):CD000072. DOI: 10.1002/14651858.CD000072.pub2. View

Fukui S, Ogawa K, Ohtsuka M, Fukui N . A randomized study assessing the efficacy of communication skill training on patients' psychologic distress and coping: nurses' communication with patients just after being diagnosed with cancer. Cancer. 2008; 113(6):1462-70. DOI: 10.1002/cncr.23710. View

Back A, Arnold R, Baile W, Tulsky J, Fryer-Edwards K . Approaching difficult communication tasks in oncology. CA Cancer J Clin. 2005; 55(3):164-77. DOI: 10.3322/canjclin.55.3.164. View

Peretti-Watel P, BenDiane M, Pegliasco H, Lapiana J, Favre R, Galinier A . Doctors' opinions on euthanasia, end of life care, and doctor-patient communication: telephone survey in France. BMJ. 2003; 327(7415):595-6. PMC: 194087. DOI: 10.1136/bmj.327.7415.595. View

Travado L, Grassi L, Gil F, Ventura C, Martins C . Physician-patient communication among Southern European cancer physicians: the influence of psychosocial orientation and burnout. Psychooncology. 2005; 14(8):661-70. DOI: 10.1002/pon.890. View

Sardell A, Trierweiler S . Disclosing the cancer diagnosis. Procedures that influence patient hopefulness. Cancer. 1993; 72(11):3355-65. DOI: 10.1002/1097-0142(19931201)72:11<3355::aid-cncr2820721135>3.0.co;2-d. View

Bruera E, Neumann C, Gagnon B, Brenneis C, Kneisler P, Selmser P . Edmonton Regional Palliative Care Program: impact on patterns of terminal cancer care. CMAJ. 1999; 161(3):290-3. PMC: 1230508. View

10.

Bakitas M, Lyons K, Hegel M, Balan S, Brokaw F, Seville J . Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial. JAMA. 2009; 302(7):741-9. PMC: 3657724. DOI: 10.1001/jama.2009.1198. View

11.

Ramirez A, Graham J, Richards M, Cull A, Gregory W . Mental health of hospital consultants: the effects of stress and satisfaction at work. Lancet. 1996; 347(9003):724-8. DOI: 10.1016/s0140-6736(96)90077-x. View

12.

Ramirez A, Graham J, Richards M, Cull A, Gregory W, Leaning M . Burnout and psychiatric disorder among cancer clinicians. Br J Cancer. 1995; 71(6):1263-9. PMC: 2033827. DOI: 10.1038/bjc.1995.244. View

13.

Schofield P, Beeney L, Thompson J, Butow P, Tattersall M, Dunn S . Hearing the bad news of a cancer diagnosis: the Australian melanoma patient's perspective. Ann Oncol. 2001; 12(3):365-71. DOI: 10.1023/a:1011100524076. View

14.

Friedrichsen M, Strang P . Doctors' strategies when breaking bad news to terminally ill patients. J Palliat Med. 2003; 6(4):565-74. DOI: 10.1089/109662103768253678. View

15.

Ptacek J, Ptacek J . Patients' perceptions of receiving bad news about cancer. J Clin Oncol. 2001; 19(21):4160-4. DOI: 10.1200/JCO.2001.19.21.4160. View

16.

Buckman R . Breaking bad news: why is it still so difficult?. Br Med J (Clin Res Ed). 1984; 288(6430):1597-9. PMC: 1441225. DOI: 10.1136/bmj.288.6430.1597. View

17.

Trufelli D, Bensi C, Garcia J, Narahara J, Abrao M, Diniz R . Burnout in cancer professionals: a systematic review and meta-analysis. Eur J Cancer Care (Engl). 2008; 17(6):524-31. DOI: 10.1111/j.1365-2354.2008.00927.x. View

18.

Parker P, Baile W, de Moor C, Lenzi R, Kudelka A, Cohen L . Breaking bad news about cancer: patients' preferences for communication. J Clin Oncol. 2001; 19(7):2049-56. DOI: 10.1200/JCO.2001.19.7.2049. View

19.

Fellowes D, Wilkinson S, Moore P . Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database Syst Rev. 2003; (2):CD003751. DOI: 10.1002/14651858.CD003751. View

20.

Krasner M, Epstein R, Beckman H, Suchman A, Chapman B, Mooney C . Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009; 302(12):1284-93. DOI: 10.1001/jama.2009.1384. View