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Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis.

Publication ,  Journal Article
Robinson, TM; Alexander, SC; Hays, M; Jeffreys, AS; Olsen, MK; Rodriguez, KL; Pollak, KI; Abernethy, AP; Arnold, R; Tulsky, JA
Published in: Support Care Cancer
September 2008

GOALS OF WORK: Advanced cancer patients' perceptions of prognosis, which are often overly optimistic compared to oncologist estimates, influence treatment preferences. The predictors of patients' perceptions and the effect of oncologist communication on patient understanding are unclear. This study was designed to identify the communication factors that influence patient-oncologist concordance about chance of cure. MATERIALS AND METHODS: We analyzed audiorecorded encounters between 51 oncologists and 141 advanced cancer patients with good (n = 69) or poor (n = 72) concordance about chance of cure. Encounters were coded for communication factors that might influence oncologist-patient concordance, including oncologist statements of optimism and pessimism. MAIN RESULTS: Oncologists made more statements of optimism (mean = 3.3 per encounter) than statements of pessimism (mean = 1.2 per encounter). When oncologists made at least one statement of pessimism, patients were more likely to agree with their oncologist's estimated chance of cure (OR = 2.59, 95%CI = 1.31-5.12). Statements of optimism and uncertainty were not associated with an increased likelihood that patients would agree or disagree with their oncologists about chance of cure. CONCLUSIONS: Communication of pessimistic information to patients with advanced cancer increases the likelihood that patients will report concordant prognostic estimates. Communication of optimistic information does not have any direct effect. The best communication strategy to maximize patient knowledge for informed decision making while remaining sensitive to patients' emotional needs may be to emphasize optimistic aspects of prognosis while also consciously and clearly communicating pessimistic aspects of prognosis.

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Published In

Support Care Cancer

DOI

ISSN

0941-4355

Publication Date

September 2008

Volume

16

Issue

9

Start / End Page

1049 / 1057

Location

Germany

Related Subject Headings

  • Prognosis
  • Pilot Projects
  • Physician-Patient Relations
  • Perception
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Health Knowledge, Attitudes, Practice
 

Citation

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Robinson, T. M., Alexander, S. C., Hays, M., Jeffreys, A. S., Olsen, M. K., Rodriguez, K. L., … Tulsky, J. A. (2008). Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis. Support Care Cancer, 16(9), 1049–1057. https://doi.org/10.1007/s00520-007-0372-2
Robinson, Tracy M., Stewart C. Alexander, Margie Hays, Amy S. Jeffreys, Maren K. Olsen, Keri L. Rodriguez, Kathryn I. Pollak, Amy P. Abernethy, Robert Arnold, and James A. Tulsky. “Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis.Support Care Cancer 16, no. 9 (September 2008): 1049–57. https://doi.org/10.1007/s00520-007-0372-2.
Robinson TM, Alexander SC, Hays M, Jeffreys AS, Olsen MK, Rodriguez KL, et al. Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis. Support Care Cancer. 2008 Sep;16(9):1049–57.
Robinson, Tracy M., et al. “Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis.Support Care Cancer, vol. 16, no. 9, Sept. 2008, pp. 1049–57. Pubmed, doi:10.1007/s00520-007-0372-2.
Robinson TM, Alexander SC, Hays M, Jeffreys AS, Olsen MK, Rodriguez KL, Pollak KI, Abernethy AP, Arnold R, Tulsky JA. Patient-oncologist communication in advanced cancer: predictors of patient perception of prognosis. Support Care Cancer. 2008 Sep;16(9):1049–1057.
Journal cover image

Published In

Support Care Cancer

DOI

ISSN

0941-4355

Publication Date

September 2008

Volume

16

Issue

9

Start / End Page

1049 / 1057

Location

Germany

Related Subject Headings

  • Prognosis
  • Pilot Projects
  • Physician-Patient Relations
  • Perception
  • Oncology & Carcinogenesis
  • Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Health Knowledge, Attitudes, Practice