Patients’ reflections on communication in the second-opinion hematology–oncology consultation

Abstract

OBJECTIVE-The nature of communication between patients and their second-opinion hematology consultants may be very different in these one-time consultations than for those that are within long-term relationships. This study explored patients' perceptions of their second-opinion hematology oncology consultation to investigate physician-patient communication in malignant disease at a critical juncture in cancer patients' care and decision-making.METHODS-In-depth telephone interviews with a subset of 20 patients from a larger study, following their subspecialty hematology consultations.RESULTS-Most patients wanted to contribute to the consultation agenda, but were unable to do so. Patients sought expert and honest advice delivered with empathy, though most did not expect the consultant to directly address their emotions. They wanted the physician to apply his/her knowledge to the specifics of their individual cases, and were disappointed and distrustful when physicians cited only general prognostic statistics. In contrast, physicians' consideration of the unique elements of patients' cases, and demonstrations of empathy and respect made patients' feel positively about the encounter, regardless of the prognosis.Corresponding author contact information: Roberta E. Goldman, PhD, Memorial Hospital of Rhode Island, Center for Primary Care and Prevention, 111 Brewster Street, Pawtucket, RI 02860, USA, Tel: 401-729-2924, Fax: 401-729-2494, roberta_goldman@mhri.org and roberta_goldman@dfci.harvard.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

Is communication guidance mistaken? Qualitative study of parent–oncologist communication in childhood cancer

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