Dumping the information bucket: A qualitative study of clinicians caring for patients with early stage non-small cell lung cancer. Issue 5 (May 2017)

• Record Type: Journal Article
• Authors: Golden, Sara E.; Thomas, Charles R.; Moghanaki, Drew; Slatore, Christopher G.
• Is Part Of: Patient education and counseling. Volume 100:Issue 5(2017)
• Page Start: 861
• Page End: 870
• Publication Date: 2017-05
• Subjects: Thoracic diseases -- Patient-centered outcomes -- Communication; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2016.12.023
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Qualitative experience of clinicians managing patients with lung cancer. Importance of providing information, especially in regard to mitigating worry. Question if shared decision making relevant in this context. Recommendations to improve treatment communication. 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.