Physicians’ responses to advanced cancer patients’ existential concerns: A video-based analysis

Larsen, Berit Hofset; Lundeby, Tonje; Gulbrandsen, Pål; Før­de, Rei­dun; Gerwing, Jennifer

doi:10.1016/j.pec.2022.06.007

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…The more important are the statements of our participants that personal values are not addressed or expressed in medical encounters as patients even think that there is no space in the conversations with their physicians for this. In the last years research has described this phenomenon in modern medicine as existential neglect [36,37]. Although patients wish that physicians take a personal interest in them, this often remains unful lled.…”

Section: Resultsmentioning

confidence: 99%

Exploring personal values of patients with advanced lung cancer in the hospital setting: a mixed-methods study

Villalobos,

Ludwig,

König

et al. 2024

Preprint

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Purpose Guidelines recommend the discussion of treatment and care goals of patients with advanced cancer according to their values and preferences. Little is known about the value system of these patients and how to address them in the hospital setting. Methods Convergent mixed-methods design: collection of quantitative data of patients with advanced lung cancer from a German University Hospital (n = 66) using the Human Values Scale, group comparison after a propensity score matching with the German cohort of the 9th European Social Survey, semi-structured interviews (n = 17) and qualitative content analysis, integration of data using side-by-side display. Results Quantitative analysis shows that lung cancer patients prioritize significantly more the value dimensions of self-transcendence (universalism, benevolence; p = .02) and openness to change (self-direction, stimulation; p = .03). While values of conservation (conformity, tradition, security; p = .04) and self-enhancement (power, achievement; p = .02) are notably less important. Besides the affirmation of self-direction, qualitative data, contrastingly, shows strong “conformity” with medical treatment decisions and the importance of “security”, while revealing the systematic neglect of values in patient-physician conversations. Conclusions The values guiding lung cancer patients differ from the general population. Despite the expressed importance of self-direction strong conformity arises in regard to medical treatment decisions. This may show the need of feeling secure in a complex and uncertain setting but has also the risk of over-treatment, hazarding goal-concordant care and the timely integration of palliative care, particularly when considering the neglect of values exposed.

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Section: Resultsmentioning

confidence: 99%

Exploring personal values of patients with advanced lung cancer in the hospital setting: a mixed-methods study

Villalobos,

Ludwig,

König

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…However, clinicians often struggle to address the existential dimension of relationship-centered care, which can result in existential neglect 11. When a patient's existential concerns (such as uncertainty about the future or searching for hope) arise in conversation, clinicians routinely steer the discussion back to biomedical aspects of care 12. Existential neglect and default biomedical framing may harm both patients and clinicians.…”

Section: Existential Experiences In Serious Illnessmentioning

confidence: 99%

“…11 When a patient's existential concerns (such as uncertainty about the future or searching for hope) arise in conversation, clinicians routinely steer the discussion back to biomedical aspects of care. 12 Existential neglect and default biomedical framing may harm both patients and clinicians. Palliative care clinicians across disciplines report feeling helpless when faced with nonphysical suffering, 13 adding to their feelings of inadequacy, failure, and distress.…”

Section: Existential Experiences In Serious Illnessmentioning

confidence: 99%

Existential Care in Daily Nursing Practice

Tarbi,

Broden,

Rosa

et al. 2023

AJN, American Journal of Nursing

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Relationship-centered palliative nursing during serious illness requires existential care. Yet, multilevel systemic barriers hinder nurses' ability to provide this care. The authors suggest ways to navigate these barriers, highlighting existential care priorities that nurses can attend to in their daily practice. These include 1) maintaining a strengths-based orientation, 2) taking a life course perspective, 3) grounding care firmly in relationships, and 4) responding moment to moment. They propose that by emphasizing existential care in palliative nursing, we can create a more compassionate and human-centered health system.

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Chapter 2. Microanalysis of Clinical Interaction (MCI)

Gerwing,

Healing,

Menichetti

2023

A Pragmatic Agenda for Healthcare

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A pragmatic agenda for clinical communication must derive sound practice recommendations based on investigations of actual clinical practice rather than idealized practice. While it is reasonable to recommend that clinicians foster the inclusion and active participation of their patients, if such recommendations are based on top-down ideals rather than a sound, bottom-up empirical base, they are vulnerable to implementation challenges. This chapter introduces microanalysis of clinical interaction (MCI), which uses videorecorded consultations between clinicians and patients to reveal authentic communicative practice in interaction. We will briefly describe its history, unique features and affordances, and examples from studies that have applied it. We then focus on its potential utility for explicating how to accomplish patients’ inclusion and active participation in interaction.

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Physicians’ responses to advanced cancer patients’ existential concerns: A video-based analysis

Cited by 6 publications

References 26 publications

Exploring personal values of patients with advanced lung cancer in the hospital setting: a mixed-methods study

Exploring personal values of patients with advanced lung cancer in the hospital setting: a mixed-methods study

Existential Care in Daily Nursing Practice

Chapter 2. Microanalysis of Clinical Interaction (MCI)

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