Cancer Communication Outside of the Physician-Patient Relationship: The Experience of Communicating and Understanding the Meaning of Prognosis

Abstract

Research Question: How does the process of engagement and integration of sources of information outside patient–physician interaction affect how individuals with cancer interpret their treatment experience and prognosis? Background: Studies of patient–physician communication of prognosis in oncology highlight areas where misunderstanding occurs: understanding consequences of treatment, likelihood of treatment success, probability of cure, status/progression of illness, and prognosis. Theories proposing mechanisms that underlie this discrepancy cannot account for all instances of misunderstanding, including when complete and direct physician disclosure occurs. Prior research focused on patient–physician communication event(s) and immediate antecedents and consequences. However, less is known about what happens to information once it has been communicated and how a patient’s process to interpret the meaning of their experience affects their understanding of it. Our study explores this question by examining patient communication with sources of information other than treating physicians. Methodology: We conducted 10 semi-structured qualitative interviews with individuals diagnosed with 4 types of cancer at different stages. The interviews were analyzed using inductive qualitative analysis. Results: Participants in our sample consulted a variety of additional sources to give context and understanding to their communicated prognosis. These were important contributors to how they understood their prognosis and incorporated that understanding. They included family, friends/acquaintances, cancer survivors, support/survivor groups, secondary health-care staff, and relevant informational materials. Different motivations for seeking out these sources were also expressed. Participants expressed a link between their understanding of their prognosis and the variety of outside sources they enlisted for input and support.

Relationship between Perceived Social Support and Health Behavior in Stroke Patients: the Mediating Role of Recurrence Risk Perception

“…In addition, there is a signi cant positive correlation between perceived social support and recurrence risk perception. This nding has also been proved in past studies [25,41]. For example, Lin [41] investigated stroke survivors' perception of their risk of recurrence and healthy behavioral modi cations.…”

“…Therefore, the relationship between recurrence risk perception and health behavior is unclear for the time being. A patient's recurrence risk perception depends not only on himself, but also on those close to them [24], such as family members, support groups, non-physician healthcare personnel, and educational material that could modify their recurrence risk perception [25]. Namely, social support is effective to improve recurrence risk perception as an extrinsic support factor [26].…”

Estimation of Risk of Recurrence and Toxicity Among Oncologists and Patients With Resected Breast Cancer: A Quantitative Study

“…Other studies also point to the effect of other sources of information, such as relatives, cancer survivors, support groups, non-physician healthcare personnel, and educational material that could modify patients' perception of risk of relapse (Adamson et al, 2019).…”

“…The few studies found reveal that agreement between patients and oncologists regarding the benefits and risks involved with adjuvancy is poor (Siminoff et al, 1989) and that patients are apt to overestimate the curative value of adjuvant therapy in 70-80% of the cases with respect to non-treatment (Ravdin et al, 1998). The optimistic confidence in treatment may reflect trouble in physician-patient communication (Mackillop et al, 1988), the influence of other sources of information (Adamson et al, 2019), or patients' minimizing or denying that cancer can be life-threatening (Mackillop et al, 1988;Wakiuchi et al, 2019).…”

Mediation role of perceived social support between recurrence risk perception and health behaviour among patients with stroke in China: a cross-sectional study

“…According to the CSM, we speculated the effect of recurrence risk perception on health behaviour was partly mediated by PSS. Nevertheless, there is a significant gap in the knowledge regarding the impact of an individual’s perception of stroke recurrence risk on their sense of social support and subsequent emotional consequences 31. In fact, in traditional Chinese philosophy, the concepts of ‘recurrence’ and ‘risk’ are often met with fear and apprehension.…”