PURPOSE: Adequate understanding of the goals and adverse effects of cancer treatment has important implications for patients' decision making, expectations, and mood. This study sought to identify the degree to which patients and clinicians agreed upon the goals and adverse effects of treatment (ie, concordance). METHODS: Patients completed a demographic questionnaire, the National Comprehensive Cancer Network Distress Thermometer, the Medical Outcomes Study Social Support Survey, the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-General questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being questionnaire, and a 13-item questionnaire about the goals and adverse effects of treatment. Providers completed a 12-item questionnaire. RESULTS: One hundred patients (51 female) and 34 providers participated (questionnaire return rate mean difference, 5 days; SD, 16 days). Patient and provider dyads agreed 61% of the time regarding the intent of treatment. In cases of nonagreement, 36% of patients reported more optimistic therapy goals compared to providers. Patients and providers agreed 69% of the time regarding the patient's acknowledgement and understanding of adverse effects. Patients who reported an understanding of likely adverse effects endorsed significantly lower distress scores (mean, 2.5) than those who endorsed not understanding associated adverse effects (mean, 4.1; P = .008). CONCLUSION: Timely data capturing of patient-provider dyadic ratings is feasible. A significant discrepancy exists between a substantial percentage of patients' and providers' views of the intent and adverse effects of treatment. Patients were almost always more optimistic about the intent of treatment. Higher rates of distress were noted in cases of discordance. Providers may benefit from conversational feedback from patients as well as other integrated feedback systems to inform them about patient understanding.
PURPOSE: Adequate understanding of the goals and adverse effects of cancer treatment has important implications for patients' decision making, expectations, and mood. This study sought to identify the degree to which patients and clinicians agreed upon the goals and adverse effects of treatment (ie, concordance). METHODS:Patients completed a demographic questionnaire, the National Comprehensive Cancer Network Distress Thermometer, the Medical Outcomes Study Social Support Survey, the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-General questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being questionnaire, and a 13-item questionnaire about the goals and adverse effects of treatment. Providers completed a 12-item questionnaire. RESULTS: One hundred patients (51 female) and 34 providers participated (questionnaire return rate mean difference, 5 days; SD, 16 days). Patient and provider dyads agreed 61% of the time regarding the intent of treatment. In cases of nonagreement, 36% of patients reported more optimistic therapy goals compared to providers. Patients and providers agreed 69% of the time regarding the patient's acknowledgement and understanding of adverse effects. Patients who reported an understanding of likely adverse effects endorsed significantly lower distress scores (mean, 2.5) than those who endorsed not understanding associated adverse effects (mean, 4.1; P = .008). CONCLUSION: Timely data capturing of patient-provider dyadic ratings is feasible. A significant discrepancy exists between a substantial percentage of patients' and providers' views of the intent and adverse effects of treatment. Patients were almost always more optimistic about the intent of treatment. Higher rates of distress were noted in cases of discordance. Providers may benefit from conversational feedback from patients as well as other integrated feedback systems to inform them about patient understanding.
Authors: Ellen G Engelhardt; Arwen H Pieterse; Anja van der Hout; Hanneke J C J M de Haes; Judith R Kroep; Patricia Quarles van Ufford-Mannesse; Johanneke E A Portielje; Ellen M A Smets; Anne M Stiggelbout Journal: Eur J Cancer Date: 2016-08-15 Impact factor: 9.162
Authors: J C Weeks; E F Cook; S J O'Day; L M Peterson; N Wenger; D Reding; F E Harrell; P Kussin; N V Dawson; A F Connors; J Lynn; R S Phillips Journal: JAMA Date: 1998-06-03 Impact factor: 56.272
Authors: John D Peipert; Jennifer L Beaumont; Rita Bode; Dave Cella; Sofia F Garcia; Elizabeth A Hahn Journal: Qual Life Res Date: 2013-09-24 Impact factor: 4.147
Authors: Dean Schillinger; John Piette; Kevin Grumbach; Frances Wang; Clifford Wilson; Carolyn Daher; Krishelle Leong-Grotz; Cesar Castro; Andrew B Bindman Journal: Arch Intern Med Date: 2003-01-13
Authors: Robert Gramling; Kevin Fiscella; Guibo Xing; Michael Hoerger; Paul Duberstein; Sandy Plumb; Supriya Mohile; Joshua J Fenton; Daniel J Tancredi; Richard L Kravitz; Ronald M Epstein Journal: JAMA Oncol Date: 2016-11-01 Impact factor: 31.777
Authors: Erin M Bange; Abigail Doucette; Peter E Gabriel; Florence Porterfield; James J Harrigan; Robin Wang; Andrzej P Wojcieszynski; Ben Boursi; Bethany I Mooney; Kim A Reiss; Ronac Mamtani Journal: JCO Oncol Pract Date: 2020-03-04