Decision-making in oncology

Ménard, Catherine; Merckaert, Isabelle; Razavi, Darius; Libert, Yves

doi:10.1097/cco.0b013e328354b2f6

Cited by 31 publications

(32 citation statements)

References 68 publications

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“…Moreover, improving communication between physicians and patients about uncertainty and hope may increase patient satisfaction with healthcare and fulfill patient desire for information and maintenance of hope [6, 9, 34]. In addition, effective communication may improve patient adjustment to cancer [1, 7, 17], quality of life, maintenance of a positive outlook on future treatments and decrease decisional conflict and regret [1, 18]. Future studies should further assess the usefulness of the CST program used in the current study on all these outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore important for physicians to provide emotional support to patients and their relatives coping with a disease associated with negative outcomes such as treatment side-effects and shortened life-expectancy. It is important to underline that current cancer treatments are increasingly personalized and based on multidisciplinary approaches [1–3]. Due to medical progress, cancer patients are living longer with their disease, posing new challenges in doctor-patient communication to help patients cope with uncertainty and to promote hope.…”

Section: Introductionmentioning

confidence: 99%

“…Prior studies have indicated that cancer patients have an expectation that physicians will discuss uncertainty and hope [4] to help them adjust to their diagnosis [1, 5, 6] and to maintain hopefulness [7–9]. Moreover, patients wish for realistic, individualized, full and honest information regarding their current medical condition and prognosis [8, 10–14].…”

Section: Introductionmentioning

confidence: 99%

“…Models of coping with cancer [5] argue that communication between physicians and patients about uncertainty may improve patient adjustment to their illness. According to these models, communication about uncertainty and hope will benefit patient quality of life, help the patient maintain a positive outlook and will decrease conflict between physicians and patients when making decisions [1, 17, 18]. These models underline the importance of effective communication skills between physicians and their cancer patients concerning uncertainty and hope [17, 19].…”

Section: Introductionmentioning

confidence: 99%

“…The efficacy of CST programs aimed at improving physician communication skills on the topics of uncertainty and hope has not yet been studied [1, 46]. These topics require specific CST.…”

Section: Introductionmentioning

confidence: 99%

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Communication about uncertainty and hope: A randomized controlled trial assessing the efficacy of a communication skills training program for physicians caring for cancer patients

et al. 2017

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BackgroundAlthough previous studies have reported the efficacy of communication skills training (CST) programs, specific training addressing communication about uncertainty and hope in oncology has not yet been studied. This paper describes the study protocol of a randomized controlled trial assessing the efficacy of a CST program aimed at improving physician ability to communicate about uncertainty and hope in encounters with cancer patients.Methods/designPhysician participants will be randomly assigned in groups (n = 3/group) to a 30-h CST program (experimental group) or to a waiting list (control group). The training program will include learner-centered, skills-focused, practice-oriented techniques. Training efficacy is assessed in the context of an encounter with a simulated advanced stage cancer patient at baseline and after the CST for the experimental group, and after four months for the waiting-list group. Efficacy assessments will include communicational, psychological and physiological measures. Group-by-time effects will be analyzed using a generalized estimating equation (GEE). A power analysis indicated that a sample size of 60 (30 experimental and 30 control) participants will be sufficient to detect effects.DiscussionThe current study will aid in the development of effective CST programs to improve physician ability to communicate about uncertainty and hope in encounters with cancer patients.Trial registrationUS Clinical Trials Register NCT02836197.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The efficacy of CST programs aimed at improving physician communication skills on the topics of uncertainty and hope has not yet been studied [1, 46]. These topics require specific CST.…”

Section: Introductionmentioning

confidence: 99%

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Communication about uncertainty and hope: A randomized controlled trial assessing the efficacy of a communication skills training program for physicians caring for cancer patients

et al. 2017

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Psychosocial care for children receiving chimeric antigen receptor (CAR) T‐cell therapy

Steineck

Wiener

Mack

et al. 2020

Pediatric Blood & Cancer

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Chimeric antigen receptor (CAR) T‐cell therapy has transformed the treatment of relapsed/refractory B‐cell acute lymphoblastic leukemia (ALL). However, this new paradigm has introduced unique considerations specific to the patients receiving CAR T‐cell therapy, including prognostic uncertainty, symptom management, and psychosocial support. With increasing availability, there is a growing need for evidence‐based recommendations that address the specific psychosocial needs of the children who receive CAR T‐cell therapy and their families. To guide and standardize the psychosocial care offered for patients receiving CAR T‐cell therapy, we propose the following recommendations for addressing psychosocial support.

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Managing brain metastases patientswith and without radiotherapy: initial lessonsfrom a team-based consult service through a multidisciplinary integrated palliative oncology clinic

Jung

Sinnarajah

Enns

et al. 2013

Support Care Cancer

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By integrating palliative care expertise to address the complex needs of patients with newly diagnosed brain metastases, end-of-life radiotherapy use appears acceptable and improved over historical rates at our institution. An appreciable proportion of patients are not suitable for palliative brain radiotherapy or opt against this treatment option, but the team approach involving nurses, palliative care experts, allied health, and clinical oncologists facilitates patient-centered decision making and transition to end-of-life care.

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Decision-making in oncology

Abstract: On the basis of these recent approaches, we propose a 'three-step model of multidisciplinary collaborative treatment decision-making' in oncology. This model should be tested for its validity.

Cited by 31 publications

References 68 publications

Communication about uncertainty and hope: A randomized controlled trial assessing the efficacy of a communication skills training program for physicians caring for cancer patients

Communication about uncertainty and hope: A randomized controlled trial assessing the efficacy of a communication skills training program for physicians caring for cancer patients

Psychosocial care for children receiving chimeric antigen receptor (CAR) T‐cell therapy

Managing brain metastases patientswith and without radiotherapy: initial lessonsfrom a team-based consult service through a multidisciplinary integrated palliative oncology clinic

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