TY - JOUR
T1 - Dumping the information bucket
T2 - A qualitative study of clinicians caring for patients with early stage non-small cell lung cancer
AU - For the Early Stage Lung Cancer Comparative Effectiveness Research Consortium
AU - Golden, Sara E.
AU - Thomas, Charles R.
AU - Moghanaki, Drew
AU - Slatore, Christopher G.
N1 - Publisher Copyright:
© 2016
PY - 2017/5
Y1 - 2017/5
N2 - 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.
AB - 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.
KW - Communication
KW - Patient-centered outcomes
KW - Thoracic diseases
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U2 - 10.1016/j.pec.2016.12.023
DO - 10.1016/j.pec.2016.12.023
M3 - Article
C2 - 28034611
AN - SCOPUS:85009231341
SN - 0738-3991
VL - 100
SP - 861
EP - 870
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 5
ER -