The ‘information spectrum’: a qualitative study of how breast cancer surgeons give information and of how their patients experience it

Abstract

Common criticisms of cancer clinicians for giving 'too little' information belie the complexity of their task in simultaneously managing information needs and hope. The 'information spectrum' could help educators and clinicians to understand this task.

Perspectives of patients with haematological cancer on how clinicians meet their information needs: “Managing” information versus “giving” it

“…The responsibility that patients give practitioners for constraining and managing information resembles that in patients with solid tumours, but is inconsistent with influential views of patients as “partners” in care, to be “empowered” by information. Indeed, only one “variant” patient took this stance, and she was unusual in the sense of medical authority she felt.…”

“…This is often unrealistic, where more information is available than could be relayed in practice. Besides, there is evidence in cancer populations including haematological cancers that patients want protection from detailed or threatening information . Practitioners are therefore sometimes guided to give patients “the information they want”, but this also can be unrealistic where patients cannot know the extent and nature of available information…”

Verbal social support for newly diagnosed breast cancer patients during surgical decision-making visits

“…11 Breast cancer surgeons are often tasked with providing information, yet keeping patients hopeful. 12 Surgeon-initiated communication has been linked to patients’ sense of choice regarding treatment and overall satisfaction with their care. 13 Similarly, a survey of breast cancer patients found the caring conveyed by their surgeon was of high importance, with information giving during this essential decision-making time valued much less.…”

O processo de comunicar notícias difíceis às mulheres com câncer de mama e suas famílias na perspectiva de profissionais de saúde

“…Uma estratégia que avaliam como importante é estimular a paciente a fazer perguntas, para permitir que ela se expresse e esclareça suas dúvidas (Mendick et al, 2013).…”

“…Para eles, essa falta de treinamento exerceu um impacto negativo em suas interações com as pacientes (Mendick et al, 2013). O treinamento desses profissionais em habilidades de comunicação faz com que eles sejam mais favoráveis a uma discussão multidisciplinar, antes de comunicar a notícia à paciente.…”