Is there a Relationship between Psychological Well-Being and Patient-Carers Consensus? A Clinical Pilot Study

Abstract

Does communication with terminal cancer patients about their disease influence their psychological well-being? The degree of patient-carer consensus about the disease was compared to psychological well-being related to acceptance of the disease, emotional state, and hope. These were evaluated and scored from 6 (good) to 0 (poor) through a semi-structured interview of 10 open-ended questions. Nineteen palliative care patients were studied, 18 of whom were suffering from advanced cancer. Overall, 57 interviews were conducted with the patients, staff nurses, and medical doctors. The answers of the carers (staff nurses and doctors) were compared to the patients’ answers to determine the degree of consensus in terms of communication about disease, aim of treatment, and ultimate objective of hospitalization. The consensus between patients and carers was scored from 6 (satisfactory) to 0 (unsatisfactory). A significant positive correlation between the scores of consensus and those of psychological well-being ( r=0.90, p<0.001) was found. These results suggest that good and truthful communication may improve patients’ psychological well-being.

Psycho‐spiritual well‐being in patients with advanced cancer: an integrative review of the literature

“…Greisinger et al (1997) found it was important for such patients to have a sense of hope, know that life has meaning and purpose, and believe that life has been productive. Similarly, several other researchers found that living with meaning and hope was a significant factor that assisted individuals to adjust their cancer illness (Taylor 1993), to reduce psychological distress and enhance their PSW and QOL (Lewis 1989, Bishara et al 1997, Axelsson & Sjoden 1998, Yang & Yin 1999, McMillan & Weitzner 2000, Morita et al 2000, and to develop a sense of a good death (Chao 1997).…”

“…They found that telling terminally ill cancer patients the truth about their diagnosis, pathology, and prognosis was related to feeling more fulfilled at the end of life. Bishara et al. (1997), using a triangulation approach, found a positive relationship between communication and psychological well‐being, and concluded that truthful communication does improve a patient's psychological well‐being.…”

“…They found that telling terminally ill cancer patients the truth about their diagnosis, pathology, and prognosis was related to feeling more fulfilled at the end of life. Bishara et al (1997), using a triangulation approach, found a positive relationship between communication and psychological wellbeing, and concluded that truthful communication does improve a patient's psychological well-being. Integrative literature reviews and meta-analyses Psycho-spiritual well-being in patients with advanced cancer Payne et al (1996a) studied hospice cancer patients (n ¼ 67) in the United Kingdom (UK) to elicit awareness of their own impending death.…”

Deciding what information is necessary: do patients with advanced cancer want to know all the details?

“…Conversely, prognostic information that is tailored to a patient’s preferences has potential to improve their psychological wellbeing 1,33. Tailored prognostic information has been found to result in higher satisfaction with care, lower anxiety and depression scores, and even improved cognitive function 34–36.…”

Evaluation of the Chemotherapy Patient Monitor: an interactive tool for facilitating communication between patients and oncologists during the cancer consultation

“…For example, survey evidence suggests that medical professionals may underestimate the distress caused by side‐effects of treatment to patients with cancer in many cases (Leonard et al 1996). Conversely, consultations characterized by more complete and accurate communication are more likely to deliver greater patient satisfaction and improved psychological well‐being (Butow et al 1995; Bishara et al 1997). Many medical professionals involved in the provision of colorectal cancer care support this view, as indicated by a survey carried out in Europe and the USA, which revealed significant support for improved information provision and education of patients (International Working Group in Colorectal Cancer.…”