Sara E Golden1, Charles R Thomas2, Drew Moghanaki3, Christopher G Slatore4. 1. Health Services Research & Development, VA Portland Health Care System, Portland, OR, USA. Electronic address: sara.golden1@va.gov. 2. Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA. Electronic address: thomasch@ohsu.edu. 3. Radiation Oncology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: dmoghanaki@vcu.edu. 4. Health Services Research & Development, VA Portland Health Care System, Portland, OR, USA; Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Department of Medicine, Oregon Health & Science University, Portland, OR, USA; Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System; Portland, OR, USA. Electronic address: christopher.slatore@va.gov.
Abstract
OBJECTIVE: To evaluate the quality of patient-clinician communication and shared decision making (SDM) when two disparate treatments for early stage non-small cell lung cancer (NSCLC) are discussed. METHODS: We conducted a qualitative study to evaluate the experiences of 20 clinicians caring for patients with clinical Stage I NSCLC prior to treatment, focusing on communication practices. We used directed content analysis and a patient-centered communication theoretical model to guide understanding of communication strategies. RESULTS: All clinicians expressed the importance of providing information, especially for mitigating patient worry, despite recognition that patients recall only a small amount of the information given. When patients expressed distress, clinicians exhibited empathy but preferred to provide more information in order to address patient concerns. Most clinicians reported practicing SDM, however, they also reported not clearly eliciting patient preferences and values, a key part of SDM. CONCLUSION: Communication with patients about treatment options for early stage NSCLC primary includes information giving. We found that only a few communication domains associated with SDM occurred regularly, and SDM may not be necessary in this clinical context. PRACTICE IMPLICATIONS: Clinicians may need to incorporate nurse navigators or more written materials for effectively discussing potentially equivalent treatment options with their patients. Published by Elsevier B.V.
OBJECTIVE: To evaluate the quality of patient-clinician communication and shared decision making (SDM) when two disparate treatments for early stage non-small cell lung cancer (NSCLC) are discussed. METHODS: We conducted a qualitative study to evaluate the experiences of 20 clinicians caring for patients with clinical Stage I NSCLC prior to treatment, focusing on communication practices. We used directed content analysis and a patient-centered communication theoretical model to guide understanding of communication strategies. RESULTS: All clinicians expressed the importance of providing information, especially for mitigating patient worry, despite recognition that patients recall only a small amount of the information given. When patients expressed distress, clinicians exhibited empathy but preferred to provide more information in order to address patient concerns. Most clinicians reported practicing SDM, however, they also reported not clearly eliciting patient preferences and values, a key part of SDM. CONCLUSION: Communication with patients about treatment options for early stage NSCLC primary includes information giving. We found that only a few communication domains associated with SDM occurred regularly, and SDM may not be necessary in this clinical context. PRACTICE IMPLICATIONS: Clinicians may need to incorporate nurse navigators or more written materials for effectively discussing potentially equivalent treatment options with their patients. Published by Elsevier B.V.
Authors: Anne C Melzer; Sara E Golden; Sarah S Ono; Santanu Datta; Kristina Crothers; Christopher G Slatore Journal: J Gen Intern Med Date: 2019-11-19 Impact factor: 5.128
Authors: Sara E Golden; Charles R Thomas; Mark E Deffebach; Mithran S Sukumar; Paul H Schipper; Brandon H Tieu; Andrew Y Kee; Andrew C Tsen; Christopher G Slatore Journal: BMC Res Notes Date: 2017-11-29
Authors: Rebecca M Schwartz; Rowena Yip; Nan You; Christina Gillezeau; Kimberly Song; David F Yankelevitz; Emanuela Taioli; Claudia I Henschke; Raja M Flores Journal: MDM Policy Pract Date: 2022-03-21