Doctor-patient communication in a cancer ward

Abstract

This study explored doctor-patient interaction by focusing on a specific type of encounter in an oncology ward, designed to enable discussion of the case by the doctors and informing the patient. In line with the cognitive orientation theory of Kreitler and Kreitler, the encounter's effects were examined in regard to three aspects--disease, treatment, and general state--on four levels: the information the patients have, their feelings, the information they desire, and the information they consider desirable. The patients were 52 men and women with different cancer diagnoses. Comparable questionnaires were administered to the patients before and after the meeting, and to the doctors only after it. The patients responded before and after also to Spielberger's scales of state anxiety and state anger. The results showed that patients claimed they had gained hardly any new information concerning the disease and their overall state. There were no decreases in the desired and desirable information. Their feelings were affected negatively to a slight extent, especially concerning treatment. In a quarter of the subjects, anxiety decreased and was replaced by anger. In regard to all levels and aspects there was a large gap between the evaluations of doctors and patients. The major conclusions were that patients and doctors differ in the meaning they assign to information, and that patients are conflicted in regard to asking for the personally relevant information they want.

An examination of the initial cancer consultation of medical and radiation oncologists using the Cancode interaction analysis system

“…Oncologists have been shown to be poor judges of patient preferences for participation, significantly underestimating cancer patients' preference for a shared approach to decision-making (Bruera et al, 2002) and desire for information. They also tend to overestimate the amount of information they believe they have given (Chaitchik et al, 1992) and cancer patients' understanding of this information (Gattellari et al, 1999). On the other hand, in one of our earlier studies, an interaction analysis of 142 consultations of cancer patients seeing a male medical oncologist, we found evidence of flexibility (Butow et al, 1995).…”

Multiple Sclerosis and Sexuality: A Survey of MS Health Professionals' Comfort, Training, and Inquiry About Sexual Dysfunction

“…They involve interactions between persons who are not in equal positions that are often nonvoluntary and emotionally charged, and that involve issues of great concern to the patient. 12 Different styles of doctor/patient interactions have been described. The first, known as "doctor/patient behavior," is goal-oriented and directed by the physician's hypotheses about what is wrong with the patient and what type of treatment should be instituted.…”

Computer-based interaction analysis of the cancer consultation

“…It is particularly important in the care of cancer patients because of their wish to be informed and involved in medical decision-making (Cassileth et al, 1980;Sutherland et al, 1989;Tattersall et al, 1994) and the legal requirements now in place for informed consent. Furthermore, interactions between cancer patients and their doctors generally concern issues of vital importance to the patient and which may be emotionally laden and can lead to psychiatric disturbance in a proportion of patients (Chiatchik et al, 1992; Derogatis et al., 1983). The possible costs of poor communication include increased anxiety, distress and coping difficulties (Cohen and lazarus, 1979), non-compliance with treatment (Cartwright, 1964), loss of confidence in staff and dissatisfaction with medical care, leading to medicolegal complaints (NSW Department of Health, 1991.…”

“…Furthermore, interactions between cancer patients and their doctors generally concern issues of vital importance to the patient and which may be emotionally laden and can lead to psychiatric disturbance in a proportion of patients (Chiatchik et al, 1992;Derogatis et al, 1983). The possible costs of poor communication include increased anxiety, distress and coping difficulties (Cohen and lazarus, 1979), non-compliance with treatment (Cartwright, 1964), loss of confidence in staff and dissatisfaction with medical care, leading to medicolegal complaints (NSW Department of Health, 1991Health, , 1992Health, , 1993.…”