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Communication in Cancer Care (PDQ®): Supportive care - Health Professional Information [NCI] - Unique Aspects of Communication with Cancer Patients

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Another study [28] identified four patterns to describe how patients' emotional styles affected treatment decision making. These styles were labeled passive, avoidant, panicked, and rational. Passive decision makers allowed directive physicians to make treatment choices for them. They responded more to the caring attitude of their provider and the need to have someone to believe in rather than to an opportunity for autonomous decision making. Women with breast cancer using an avoidant style of decision making refused to actively confront their diagnosis or participate in planning their cancer treatment. Panicked patients were so fearful when confronted with a diagnosis of cancer that they could not participate in decision making, whereas rational decision makers were able to control strong feelings of fear and engage fully in decision making.[28] Results of another study found that whereas most well people preferred to play an active role in decision making, very sick people preferred the doctor to make decisions,[14] suggesting that seriously ill people may prefer a degree of paternalism in their care because an active role in decision making may take more physical and mental energy than these patients can afford. Alternatively, there may be a limit to the amount of negative and pessimistic information people can absorb before their capacity for coping is seriously compromised.[14]

Although the categorization of patients into various participation styles appears to offer some useful predictive power for defining communication patterns, the issues are complex. It has been suggested that to match the provision of information and support with the expressed needs of patients, patients should ideally be queried frequently about their needs.[14,29] Information and involvement preferences may also be responsive to factors such as changing disease status and the behavior of the physician during consultation.[28] Individualizing treatment discussions to patients' preferred decision-making styles rather than encouraging decision-making autonomy is likely to maximize outcomes for patients with cancer.[30]

References:

  1. Tattersall MH, Butow PN, Clayton JM: Insights from cancer patient communication research. Hematol Oncol Clin North Am 16 (3): 731-43, 2002.
  2. Mitchell JL: Cross-cultural issues in the disclosure of cancer. Cancer Pract 6 (3): 153-60, 1998 May-Jun.
  3. Hietanen P, Aro AR, Holli K, et al.: Information and communication in the context of a clinical trial. Eur J Cancer 36 (16): 2096-104, 2000.
  4. Ong LM, Visser MR, Lammes FB, et al.: Doctor-patient communication and cancer patients' quality of life and satisfaction. Patient Educ Couns 41 (2): 145-56, 2000.
  5. Levy MH: Doctor-patient communication: the lifeline to comprehensive cancer care. In: Perry MC, ed.: American Society of Clinical Oncology Educational Book: Thirty-Fourth Annual Meeting, Spring 1998. Alexandria, Va: American Society of Clinical Oncology, 1998, pp 195-202.
  6. Cancer care during the last phase of life. J Clin Oncol 16 (5): 1986-96, 1998.
  7. Merckaert I, Libert Y, Razavi D: Communication skills training in cancer care: where are we and where are we going? Curr Opin Oncol 17 (4): 319-30, 2005.
  8. Back AL, Arnold RM, Baile WF, et al.: Approaching difficult communication tasks in oncology. CA Cancer J Clin 55 (3): 164-77, 2005 May-Jun.
  9. Baile WF, Aaron J: Patient-physician communication in oncology: past, present, and future. Curr Opin Oncol 17 (4): 331-5, 2005.
  10. Hagerty RG, Butow PN, Ellis PM, et al.: Communicating prognosis in cancer care: a systematic review of the literature. Ann Oncol 16 (7): 1005-53, 2005.
  11. Epstein RM, Street RL Jr: Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering. Bethesda, Md: National Cancer Institute, 2007. NIH Pub. No. 07-6225. Also available online. Last accessed September 20, 2012.
  12. Mead N, Bower P: Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med 51 (7): 1087-110, 2000.
  13. Schapira L: Communication skills training in clinical oncology: the ASCO position reviewed and an optimistic personal perspective. Crit Rev Oncol Hematol 46 (1): 25-31, 2003.
  14. Butow PN, Maclean M, Dunn SM, et al.: The dynamics of change: cancer patients' preferences for information, involvement and support. Ann Oncol 8 (9): 857-63, 1997.
  15. Lobb EA, Butow PN, Meiser B, et al.: Tailoring communication in consultations with women from high risk breast cancer families. Br J Cancer 87 (5): 502-8, 2002.
  16. Mills ME, Sullivan K: The importance of information giving for patients newly diagnosed with cancer: a review of the literature. J Clin Nurs 8 (6): 631-42, 1999.
  17. Siminoff LA, Ravdin P, Colabianchi N, et al.: Doctor-patient communication patterns in breast cancer adjuvant therapy discussions. Health Expect 3 (1): 26-36, 2000.
  18. Jenkins V, Fallowfield L, Saul J: Information needs of patients with cancer: results from a large study in UK cancer centres. Br J Cancer 84 (1): 48-51, 2001.
  19. Lobb EA, Butow PN, Kenny DT, et al.: Communicating prognosis in early breast cancer: do women understand the language used? Med J Aust 171 (6): 290-4, 1999.
  20. Schofield PE, Butow PN, Thompson JF, et al.: Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 14 (1): 48-56, 2003.
  21. Silliman RA, Dukes KA, Sullivan LM, et al.: Breast cancer care in older women: sources of information, social support, and emotional health outcomes. Cancer 83 (4): 706-11, 1998.
  22. Wright EB, Holcombe C, Salmon P: Doctors' communication of trust, care, and respect in breast cancer: qualitative study. BMJ 328 (7444): 864, 2004.
  23. Miller SM: Monitoring and blunting: validation of a questionnaire to assess styles of information seeking under threat. J Pers Soc Psychol 52 (2): 345-53, 1987.
  24. Ong LM, Visser MR, van Zuuren FJ, et al.: Cancer patients' coping styles and doctor-patient communication. Psychooncology 8 (2): 155-66, 1999 Mar-Apr.
  25. Guadagnoli E, Ward P: Patient participation in decision-making. Soc Sci Med 47 (3): 329-39, 1998.
  26. Webber GC: Patient education. A review of the issues. Med Care 28 (11): 1089-103, 1990.
  27. Pierce PF: Deciding on breast cancer treatment: a description of decision behavior. Nurs Res 42 (1): 22-8, 1993 Jan-Feb.
  28. McVea KL, Minier WC, Johnson Palensky JE: Low-income women with early-stage breast cancer: physician and patient decision-making styles. Psychooncology 10 (2): 137-46, 2001 Mar-Apr.
  29. Baile WF, Buckman R, Lenzi R, et al.: SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5 (4): 302-11, 2000.
  30. Keating NL, Guadagnoli E, Landrum MB, et al.: Treatment decision making in early-stage breast cancer: should surgeons match patients' desired level of involvement? J Clin Oncol 20 (6): 1473-9, 2002.

This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

WebMD Public Information from the National Cancer Institute

Last Updated: September 04, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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