Managing “Stable” Cancer News

Beach, Wayne A.

doi:10.1177/0190272520976133

Cited by 10 publications

(3 citation statements)

References 60 publications

(94 reference statements)

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“…Patient is aware, and oncologist confirms, that her condition is likely not curable and many prognostic uncertainties remain. An explicit and shared clinical goal stated in this interview, however, is to control her cancer as a stable but chronic health threat, with interventions designed to minimize dangerous metastasis while maintaining a reasonably high quality of living (Beach, 2021).…”

Section: Methodsmentioning

confidence: 99%

“…Addressing the complexities of patients' emotional and psychosocial concerns remains an ongoing challenge across a wide variety of clinical environments . Patient-initiated actions are frequently met with providers' avoidance and resistance, actions such as answering more than a doctor's question asked by providing extended illness stories (Stivers & Heritage, 2001), justifying wellness (Beach, 2013b), challenging and resisting doctors' authority to impose order on patients' lives (Beach, 2021;Stivers & Timmermans, 2020), or attempts to recruit doctors' support by invoking hopeful outcomes (Beach, 2014). The findings from this case study identify alternative, compassionate caring practices for sharing and attempting to assuage patients' suffering.…”

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confidence: 99%

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Enacting Woundedness and Compassionate Care for Recurrent Metastatic Breast Cancer

Beach

2021

Qual Health Res

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This analysis integrates Arthur Frank’s timeless revelations about woundedness within the communication context of an oncology interview. A Patient whose life is threatened by recurrent metastatic breast cancer claims personal knowledge and visibly demonstrates impacts from illness experiences. Conversation Analysis (CA) was conducted on a video recorded and transcribed case study involving a Patient, her husband, and co-present oncologists. By focusing on narratives as talk-in-interaction, grounded exemplars are provided of primary interactional achievements: How woundedness gets displayed and responded to with empathy and compassionate witnessing; Patient’s flooding out with emotion and potential embarrassment; attempting to regain control and resume talking about her condition; and the serial organization of crying and laughter when managing noticeably delicate moments. In this interview, woundedness is not discounted or dismissed but recognized as legitimate suffering meriting shared commiseration. Understanding how to enact humane and communicatively competent skills during emotionally uncertain moments can enhance medical education.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Enacting Woundedness and Compassionate Care for Recurrent Metastatic Breast Cancer

Beach

2021

Qual Health Res

Self Cite

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“…In addition, previous research has shown that patients and clinicians hold different perspectives and priorities concerning 2/22 disease [14,64]. For example, patients usually consider news of a 'stable' cancer as being negative, while doctors often consider this to be positive [9]. Meanwhile, analysis of an online Uveitis patient forum identified different language and priorities than those expressed by existing scientific and clinical knowledge resources [50].…”

Section: Introductionmentioning

confidence: 99%

Talking about diseases; developing a model of patient and public-prioritised disease phenotypes

Slater,

Schofield,

Wright

et al. 2023

Preprint

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BackgroundDeep phenotyping describes the use of formal and standardised terminologies to create comprehensive phenotypic descriptions of biomedical phenomena. While most often employed to describe patients, phenotype models may also be developed to characterise diseases. These characterisations facilitate secondary analysis, evidence synthesis, and practitioner awareness, thereby guiding patient care. The vast majority of this knowledge is derived from sources that describe an academic understanding of disease, including academic literature and experimental databases. Previous work has revealed a gulf between the priorities, perspectives, and perceptions held by healthcare researchers and providers and the users of clinical services. A comparison between canonical disease descriptions and phenotype models developed from public discussions of disease offers the prospect of discovery of new phenotypes, patient population stratification, and targeted mitigation of symptoms most damaging to patients quality of life.MethodsUsing a dataset representing disease and phenotype co-occurrence in social media text, we employ semantic techniques to identify phenotype associations for a set of common and rare diseases, constituting a phenotype model for those diseases that represents the public perspective. We create an integrated resource for biomedical database and literature-derived disease-phenotype associations by aligning data from several previous studies. We then explore differences between the disease-phenotype associations derived from writing in social media with those from the clinical literature and biomedical databases, with a focus on identification of differential themes and novel phenotypes. We also perform an evaluation of associations for several diseases, with specialist clinicians reviewing associations for validity, feasibility, and involvement in clinical care.FindingsWe identified 35,782 significant disease-phenotype associations from social media across 311 diseases, of which 304 could be linked to a combined resource of associations derived from academic sources. Social media-derived disease profiles recapitulated those from academic sources (AUC=0.874 (.95=0.858-0.891)). We further identified 26,081 novel phenotype associations that were not contained in the academic sources, of which 15,084 were considered significant. Constitutional symptoms, those holistic manifestations of disease affecting quality of life, were strongly over-represented in the social media phenotype, contributing more associations especially to endocrine, digestive, and reproductive diseases. An expert clinical review found that social media-derived associations were considered similarly well-established to those derived from literature, and were seen significantly more in patient clinical encounters.InterpretationThe phenotype model recovered from social media presents a significantly different perspective than existing resources derived from biomedical databases and literature, providing a large number of associations novel to the latter dataset. We propose that the integration and interrogation of these public perspectives on disease can inform clinical awareness, improve secondary analysis, and bridge understanding across healthcare stakeholders.

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Patient–Oncologist Interactions

Beach

2022

The International Encyclopedia of Health Communication

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Oncology interviews are designed to diagnose and treat cancer as a complex disease defined by cellular degeneration. Left untreated, cancer is capable of progressive growth, excessive harm, and possible death. Recurrent tensions and trusting partnerships exist between clinicians and patients as lay persons. Medical experts rely on their authority to diagnose, treat, and minimize cancer health threats. Patients are typically not trained to understand technical cancer details yet can claim knowledge about bodily and subjective illness experiences. A primary goal of health communication research is to observe how clinicians enact medical authority and impacts on patient participation. Effectively addressing the emotional concerns and well‐being of cancer patients is also essential if positive clinical outcomes are to be achieved. Across phases of medical interviews, patients have been shown to be passive and defer to clinicians' pursuit of agendas. Yet, close examinations of oncology interviews reveal that cancer patients can proactively, directly and indirectly, align with or resist those agendas. A related and predominant cancer research focus has been on dying and death, including delivering and receiving bad news and delicate end‐of‐life discussions. Recent research emphasizes how patients pursue wellness rather than sickness, life‐affirming impacts of hope and perseverance, and relationships between good and bad news. Discovering basic patterns about the interactional organization of oncology interviews can have direct implications for enhancing the quality of care provided. Significant findings are reviewed offering new knowledge that can be translated into best practices for creating informed, personalized, and compassionate care environments.

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Managing “Stable” Cancer News

Cited by 10 publications

References 60 publications

Enacting Woundedness and Compassionate Care for Recurrent Metastatic Breast Cancer

Enacting Woundedness and Compassionate Care for Recurrent Metastatic Breast Cancer

Talking about diseases; developing a model of patient and public-prioritised disease phenotypes

Patient–Oncologist Interactions

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