Patient participation in multidisciplinary tumor conferences: Providers' perceptions of patients' need satisfaction and emotional experiences

Abstract

Objective: In some breast and gynecological cancer centers in Germany, patients participate in multidisciplinary tumor conferences (MTCs) during the discussion of their own case. The aim of this study was to explore providers' perceptions concerning patients' emotional experiences during participation in an MTC by comparing the perspectives of providers with and without experience with patient participation. Methods: In this study, semi-structured interviews with n = 30 providers in n = 6 breast and gynecological cancer centers in North Rhine-Westphalia, Germany, were conducted. One half of the providers had no experience and the other half had experience with patient participation in MTCs. The interviews were audiotaped and transcribed, and content analysis was performed. Results: The results of this study show a mixed picture of met, unmet and disappointed needs of patients and their emotional reactions, which mainly overlap between both provider groups. Our results show that both provider groups report positive and negative experiences or expectations. Conclusion: The mixed results regarding expected and perceived patient experiences from the providers' perspective suggest that patient participation in MTCs may not be exclusively of benefit. Further research on advantages and disadvantages for patients and on feasibility from the providers' perspective is necessary and will be conducted within the PINTU project.

<p>Patient Participation in Multidisciplinary Tumor Conferences from the Providers’ Perspective: Is It Feasible in Routine Cancer Care?</p>

“…Furthermore, communication skills to address patients' emotional reactions were seen as highly important by providers experienced with MTCpp which we analyzed more detailed in a different publication on MTCpp. 52 Van Dongen et al and Choy et al recommend adequate support and preparation for the meeting, eg paying attention to patients' willingness and ability to participate, which were also mentioned by providers in this present study. In addition, it seems important for all necessary information to be shared with patients before the MTC.…”

Multidisziplinäre Tumorkonferenzen in Deutschland

“…Ein zentraler Aspekt bei der Umsetzung von Therapieempfehlungen basierend auf MTK-Entscheidungen ("Tumorboard-Adhärenz") ist die teils fehlende Berücksichtigung des Patientenwunsches (Baes et al 2020;Basta et al 2017;Gruber 2012;Hollunder et al 2018). Dies kann beispielsweise durch die Einbindung von Pflegepersonal (Knötgen 2020;Rosell et al 2018) oder die Teilnahme von Patientinnen und Patienten an MTK (Diekmann et al 2020;Heuser et al 2019;Bate et al 2019;Hahlweg et al 2015) erreicht werden. Letzteres wird wiederum nur in einzelnen Zentren umgesetzt und von der Ärzteschaft unterschiedlich bewertet (Heuser et al 2020).…”

Patient participation in multidisciplinary tumor conferences in breast and gynecological cancer care: How patient‐centered is the communication?

“…On the other hand, if patients are overloaded with medical information, they may react emotionally, which could disrupt the provider-patient relationship. [26][27][28] Providers object that patient participation requires more time and adjusted professional language. 26,28 Patients who participated in case discussions found them mostly helpful and informative 24,29 but also reported difficult situations and negative emotional reactions.…”

“…On the one hand, participation may allow patients to be better informed. On the other hand, if patients are overloaded with medical information, they may react emotionally, which could disrupt the provider–patient relationship 26–28 . Providers object that patient participation requires more time and adjusted professional language 26,28 .…”