Barbara Schellenberger1, Christian Heuser2, Annika Diekmann2, Lena Ansmann3, Emily Krüger2, Leonie Schreiber2, Bernt Schnettler4, Franziska Geiser5, Ingo G H Schmidt-Wolf6, Nicole Ernstmann2. 1. Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Germany; Center for Integrated Oncology (CIO), University Hospital Bonn, Germany. Electronic address: barbara.schellenberger@ukbonn.de. 2. Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Germany; Center for Integrated Oncology (CIO), University Hospital Bonn, Germany. 3. Division for Organizational Health Services Research, Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Germany. 4. Department of Sociology, University of Bayreuth, Germany. 5. Center for Integrated Oncology (CIO), University Hospital Bonn, Germany; Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Bonn, Germany. 6. Center for Integrated Oncology (CIO), University Hospital Bonn, Germany; Department of Integrated Oncology, University Hospital, Bonn, Germany.
Abstract
OBJECTIVE: To investigate (a) how many questions and negative emotions (cues/concerns) breast and/or gynecologic cancer patients and companions express during their case discussion in multidisciplinary tumor conferences (MTCs), (b) with which topics the emotions are linked, and (c) which patient- and context-related characteristics determine patients' communicative behavior. METHODS: This observational study included audio/video recordings of MTCs with patient participation in three breast and gynecological cancer centers. Using the Verona Coding Definitions of Emotional Sequences, patients' and companions' questions and negative emotions expressed were analyzed. Multiple regression analyses were used to determine associations between communicative behavior and patient- and context-related characteristics. RESULTS: We identified 607 questions and 230 cues/concerns expressed by patients/companions in 82 case discussions in MTCs. The number of questions was significantly associated with the hospital. In case discussions with patients who had need for psychological support and who were accompanied, more questions were asked by patients/companions. CONCLUSION: The results show that active patient participation does not depend only on patient characteristics, but also on the hospital setting. PRACTICE IMPLICATIONS: If cancer centers want to enable patient participation in MTCs, they must define the role of the patient before. Subsequently, conditions must be created to enable this role expectation.
OBJECTIVE: To investigate (a) how many questions and negative emotions (cues/concerns) breast and/or gynecologic cancer patients and companions express during their case discussion in multidisciplinary tumor conferences (MTCs), (b) with which topics the emotions are linked, and (c) which patient- and context-related characteristics determine patients' communicative behavior. METHODS: This observational study included audio/video recordings of MTCs with patient participation in three breast and gynecological cancer centers. Using the Verona Coding Definitions of Emotional Sequences, patients' and companions' questions and negative emotions expressed were analyzed. Multiple regression analyses were used to determine associations between communicative behavior and patient- and context-related characteristics. RESULTS: We identified 607 questions and 230 cues/concerns expressed by patients/companions in 82 case discussions in MTCs. The number of questions was significantly associated with the hospital. In case discussions with patients who had need for psychological support and who were accompanied, more questions were asked by patients/companions. CONCLUSION: The results show that active patient participation does not depend only on patient characteristics, but also on the hospital setting. PRACTICE IMPLICATIONS: If cancer centers want to enable patient participation in MTCs, they must define the role of the patient before. Subsequently, conditions must be created to enable this role expectation.
Authors: David Winston Hamilton; Benjamin Heaven; Richard Thomson; Janet Wilson; Catherine Exley Journal: BMJ Open Date: 2022-08-24 Impact factor: 3.006