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01.07.2015 | Original Article

Information preferences regarding cure rates and prognosis of Austrian patients with advanced lung cancer

verfasst von: Tamara Rumpold, M.Sc., Carola Lütgendorf-Caucig, M.D., Reinhold Jagsch, M.Sc., Ph.D., Prof. Karin Dieckmann, M.D., Prof. Herbert Watzke, M.D., Prof. Richard Pötter, M.D., Kathrin Kirchheiner, M.Sc., Ph.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 7/2015

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Abstract

Introduction

Due to concerns about patients’ wellbeing, open end-of-life communication is associated with reservation. Furthermore, sociocultural differences must be considered. The objective of this pilot study was therefore to investigate the information preferences of Austrian patients regarding cure rates and prognosis.

Patients and methods

The information preferences of 50 advanced lung cancer patients were assessed at their first visit to the Department of Radiation Oncology, Medical University of Vienna. Preferences in terms of content (cure rates and/or prognosis) and depth of the information (additional quantitative estimates) were addressed. After the individually adapted medical consultation, patients’ satisfaction with the consultation and the emotional responses to the information were evaluated.

Results

The majority of patients (76 %) requested information about cure rates and/or prognosis; nearly half of these (47 %) wanted additional quantitative estimates. Neither sociodemographic variables, disease characteristics, nor time since diagnosis had an impact on the information preferences. The individually adapted medical information showed no overall negative influence on the emotional responses; only patients receiving prognostic information had significantly higher distress scores after the consultation. High satisfaction with the individually adapted medical consultation was reported by 92 % of patients.

Conclusion

Austrian physicians may offer end-of-life communication and directly ask patients about their information preferences, since patients seem able to decide whether or not prognostic information would overwhelm their emotional capacity and therefore to accept or reject the invitation. The disclosure of cure rates and/or prognosis with or without quantitative estimates—according to the patients’ preferences—shows overall no negative impact on emotional reactions. The individually adapted consultation results in high patient satisfaction. Nevertheless, prognostic information may lead to higher distress.

Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organisation for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRef

Baile WF, Lenzi R, Parker P et al (2002) Oncologists’ attitudes toward and practices in giving bad news: an exploratory study. J Clin Oncol 20:2189–2196PubMedCrossRef

Barnett MM (2002) Effect of breaking bad news on patients’ perceptions of doctors. J R Soc Med 95:343–347PubMedCentralPubMedCrossRef

Butow PN, Maclean M (1997) The dynamics of change: cancer patients’ preferences for information, involvement and support. Ann Oncol 8:857–863PubMedCrossRef

Charles C, Gafni A, Whelan T (1997) Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med 44:681–692PubMedCrossRef

Chochinov HM, Tataryn DJ, Wilson KG et al (2000) Prognostic awareness and the terminally ill. Psychosomatics. 41:500–504PubMedCrossRef

Christakis N, Iwashyna TJ (1998) Attitude and self-reported practice regarding prognostication in a national sample of internists. Arch Intern Med 158:2389–2395PubMedCrossRef

Clayton JM, Hancock KM, Butow PN et al (2007) Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. Med J Aust 186:77–108

Elwyn G, Frosch D, Thomson R et al (2012) Shared decision making: a model for clinical practice. J Gen Intern Med 27:1361–1367PubMedCentralPubMedCrossRef

10.

Fallowfield LJ, Jenkins VA, Beveridge HA (2002) Truth may hurt but deceit hurts more: communication in palliative care. Palliat Med 16:297–303PubMedCrossRef

11.

Fayers PM, Aaronson NK, Bjordal K et al (2001) The EORTC QLQ-C30 scoring manual European Organization for Research and treatment of cancer. Brussels

12.

Field A (2009) Discovering statistics using SPSS. Sage Publications, London

13.

Gaissmaier W, Gigerenzer G (2011) When misinformed patients try to make informed health decisions. In: Gigerenzer G, Muir Gray JA (eds). Better doctors, better patients, better decisions: envisioning health care 2020. MIT Press, Cambridge, p. 29–44

14.

Gattellari M, Butow PN, Tattersall MHN et al (1999) Misunderstanding in cancer patients: why shoot the messenger? Ann Oncol 10:39–46PubMedCrossRef

15.

Georgaki S, Kalaidopoulou O, Liarmakopoulos I et al (2002) Nurses’ attitudes toward truthful communication with patients with cancer. A Greek study. Cancer Nurs 25:436–441PubMedCrossRef

16.

Hagerty RG, Butow PN, Ellis PA et al (2004) Cancer patient preferences for communication of prognosis in the metastatic setting. J Clin Oncol 22:1721–1730PubMedCrossRef

17.

Helft PR (2005) Necessary collusion: Prognostic communication with advanced cancer patients. J Clin Oncol 23:3146–3150PubMedCrossRef

18.

Huang X, Butow PN, Meiser B et al (1999) Attitudes and information needs of Chinese migrant cancer patients and their relatives. Aust N Z J Med 29:207–213PubMedCrossRef

19.

Iconomou G, Viha A, Koutra A et al (2002) Information needs and awareness of diagnosis in patients with cancer receiving chemotherapy: a report from Greece. Palliat Med 16:315–321PubMedCrossRef

20.

Kaplowitz SA, Campo S, Chiu WT (2002) Cancer patients’ desires for communication of prognosis information. Health Commun 14:221–241PubMedCrossRef

21.

Krasner MS, Epstein RM, Beckman H et al (2009) Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. J Am Med Assoc 302:1284–1293CrossRef

22.

Laine C, Davidoff F (1996) Patient-centered medicine: a professional evolution. J Am Med Assoc 275:152–156CrossRef

23.

Mack JW, Smith TJ (2012) Reasons why physicians do not have discussions about poor prognosis, why it matters, and what can be improved. J Clin Oncol 30:2715–2717PubMedCrossRef

24.

Mystakidou K, Parpa E, Tsilila E et al (2004) Cancer information disclosure in different cultural contexts. Support Care Cancer 12:147–154PubMedCrossRef

25.

Ngo-Metzger Q, August KJ, Srinivasan M et al (2008) End-of-life care: guidelines for patient-centered communication. Am Fam Physician 77:167–74PubMed

26.

Pieterse AH, Jager N, Smets EM et al (2013) Lay understanding of common medical terminology in oncology. Psychooncology 22:1186–1191PubMedCrossRef

27.

Republik Österreich (2006) BGBl I 2006/42

28.

Schofield PE, Butow PN, Thompson JF et al (2003) Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 14:48–56PubMedCrossRef

29.

Surbone A (2008) Cultural aspects of communication in cancer care. Support Care Cancer 16:235–240PubMedCrossRef

30.

Temel JS, Greer JA, Muzikansky A et al (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363:733–742PubMedCrossRef

31.

The AM, Hak T, Koëter G et al (2001) Collusion in doctor-patient communication about imminent death: an ethnographic study. West J Med 174:247–53PubMedCentralPubMedCrossRef

32.

Uchitomi Y, Yamawaki S (1997) Truth-telling practice in cancer care in Japan. Ann N Y Acad Sci 809:290–299PubMedCrossRef

33.

Vandekieft GK (2001) Breaking bad news. Am Fam Physician 64:1975–1978PubMed

Titel: Information preferences regarding cure rates and prognosis of Austrian patients with advanced lung cancer
verfasst von: Tamara Rumpold, M.Sc.
Carola Lütgendorf-Caucig, M.D.
Reinhold Jagsch, M.Sc., Ph.D.
Prof. Karin Dieckmann, M.D.
Prof. Herbert Watzke, M.D.
Prof. Richard Pötter, M.D.
Kathrin Kirchheiner, M.Sc., Ph.D.
Publikationsdatum: 01.07.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 7/2015
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-015-0816-4

Springer Medizin

Information preferences regarding cure rates and prognosis of Austrian patients with advanced lung cancer