Communication of prognosis in head and neck cancer patients; a descriptive qualitative analysis.
Oral Oncol
; 84: 76-81, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-30115480
ABSTRACT
OBJECTIVES:
In shared decision making it is important to adequately, timely and actively involve patients in treatment decisions. Sharing prognostic information can be of key importance. This study describes whether and how prognostic information on life expectancy is included during communication on diagnosis and treatment plans between physicians and head and neck (H&N) oncologic patients in different phases of disease.METHODS:
A descriptive, qualitative study was performed of nâ¯=â¯23 audiotaped physician-patient conversations in which both palliative and curative treatment options were discussed and questions on prognosis were expected. Verbatim transcribed consultations were systematically analyzed. A distinction was made between prognostic information that was provided (a) quantitatively by giving numerical probability estimates, such as percentages or years or (b) qualitatively through the use of words such as 'most likely' or 'highly improbable'.RESULTS:
In all consultations, H&N surgeons provided some prognostic information. In 5.9% of the provided prognostic information, a quantitative method was used. In 94.1% prognostic information was provided qualitatively, using six identified approaches. H&N surgeons possibly affect patients' perception of prognostic content with two identified communication styles directive (more physician-centered) and affective (more patient-centered).CONCLUSION:
This study is first in providing examples of how H&N surgeons communicate with their patients regarding prognosis in all stages of disease. They often exclude specific prognostic information. The study outcomes can be used as a first step in developing a guideline for sharing prognostic information in H&N oncologic patients, in order enable the process of shared decision making.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Relações Médico-Paciente
/
Revelação da Verdade
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Tomada de Decisões
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Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Guideline
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Prognostic_studies
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Qualitative_research
Limite:
Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Oral Oncol
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2018
Tipo de documento:
Article