Nicci Bartley1, Megan C Best2, Barbara B Biesecker3, Alana Fisher4, David Goldstein5, Bettina Meiser6, David M Thomas7, Mandy L Ballinger8, Phyllis Butow9. 1. School of Psychology, The University of Sydney, Sydney, Australia. Electronic address: nicole.bartley@sydney.edu.au. 2. School of Psychology, The University of Sydney, Sydney, Australia; Institute of Ethics and Society, The University of Notre Dame, Sydney, Australia. Electronic address: megan.best@nd.edu.au. 3. Research Triangle Institute, Bethesda, USA. Electronic address: bbiesecker@rti.org. 4. School of Psychology, The University of Sydney, Sydney, Australia. Electronic address: a.fisher@sydney.edu.au. 5. Prince of Wales Clinical School, University of NSW, Sydney, Australia. Electronic address: d.goldstein@unsw.edu.au. 6. Psychosocial Research Group, Prince of Wales Clinical School, University of NSW, Sydney, Australia. Electronic address: b.meiser@unsw.edu.au. 7. Cancer Theme, Garvan Institute of Medical Research, Sydney, Australia; St Vincent's Clinical School, University of NSW, Sydney, Australia. Electronic address: d.thomas@garvan.org.au. 8. Cancer Theme, Garvan Institute of Medical Research, Sydney, Australia; St Vincent's Clinical School, University of NSW, Sydney, Australia. Electronic address: m.ballinger@garvan.org.au. 9. School of Psychology, The University of Sydney, Sydney, Australia. Electronic address: phyllis.butow@sydney.edu.au.
Abstract
OBJECTIVE: To understand advanced cancer patients' experience of uncertainty when receiving comprehensive tumor genomic profiling (CTGP) results, and their perceptions of how healthcare provider (HCP) communication impacts uncertainty. METHODS: Thirty-seven semi-structured interviews with advanced cancer patients were conducted within two weeks of patients receiving CTGP results. Transcripts were thematically analyzed, using an inductive approach. RESULTS: We identified three themes that illustrate patient experience of uncertainties when receiving CTGP results: 1. Type and degree of uncertainty fluctuates along with changing illness circumstances and the nature of the CTGP results; 2. HCPs' co-ordination of care and communication shapes uncertainty, with immediate, clearer and simpler information promoting certainty; and 3. Patients felt that communicating results to reduce relatives' uncertainty is important, with patients choosing the time and process for achieving this and desiring HCPs support. CONCLUSION: Oncology patients are confronted with an array of uncertainties. Clear, simple communication from HCPs about results and their implications, and support to manage uncertainty, will be of benefit. PRACTICE IMPLICATIONS: If CTGP is to become routine clinical practice, clear communication will be crucial in reducing uncertainty. Awareness of potential uncertainties experienced by patients when receiving results, will assist HCPs to address uncertainties, reduce uncertainty where possible, and offer targeted support to patients struggling with uncertainty.
OBJECTIVE: To understand advanced cancer patients' experience of uncertainty when receiving comprehensive tumor genomic profiling (CTGP) results, and their perceptions of how healthcare provider (HCP) communication impacts uncertainty. METHODS: Thirty-seven semi-structured interviews with advanced cancer patients were conducted within two weeks of patients receiving CTGP results. Transcripts were thematically analyzed, using an inductive approach. RESULTS: We identified three themes that illustrate patient experience of uncertainties when receiving CTGP results: 1. Type and degree of uncertainty fluctuates along with changing illness circumstances and the nature of the CTGP results; 2. HCPs' co-ordination of care and communication shapes uncertainty, with immediate, clearer and simpler information promoting certainty; and 3. Patients felt that communicating results to reduce relatives' uncertainty is important, with patients choosing the time and process for achieving this and desiring HCPs support. CONCLUSION: Oncology patients are confronted with an array of uncertainties. Clear, simple communication from HCPs about results and their implications, and support to manage uncertainty, will be of benefit. PRACTICE IMPLICATIONS: If CTGP is to become routine clinical practice, clear communication will be crucial in reducing uncertainty. Awareness of potential uncertainties experienced by patients when receiving results, will assist HCPs to address uncertainties, reduce uncertainty where possible, and offer targeted support to patients struggling with uncertainty.
Authors: Megan C Best; Nicci Bartley; Christine E Napier; Alana Fisher; Mandy L Ballinger; David M Thomas; David Goldstein; Katherine Tucker; Barbara B Biesecker; Phyllis Butow Journal: Support Care Cancer Date: 2022-07-09 Impact factor: 3.359