title: Perceived difficulties in consulting with patients and families: a survey of Australian cancer specialists.
abstract: OBJECTIVE
  To determine what aspects of communicating and consulting with cancer patients are viewed as difficult and stressful by cancer specialists in Australia.
  
  
  METHODS
  Anonymous, cross-sectional, Internet-based survey completed by 134 cancer specialists between June and August 2007. Participants, who were all members of the Clinical Oncological Society of Australia, included oncologists and palliative care specialists.
  
  
  METHODS
  Degree of difficulty perceived for various consultation tasks; level of stress reported during various practice-related situations.
  
  
  RESULTS
  Doctors had the most difficulty discussing high-cost drugs with patients they knew could not afford them, followed by topics relating to treatment failure. They had the least difficulty telling patients they had cancer or being honest about prognosis. The most stressful practice situations included having incomplete patient information to conduct the consultation and having a long line of patients waiting for a consultation. At least 62% of respondents reported experiencing some degree of stress in all the practice situations presented. There were differences in difficulty and stress experienced as a function of the doctor's sex, age and clinical experience.
  
  
  CONCLUSIONS
  Targeted, evidence-based guidelines and communication courses are required to better equip cancer specialists for providing non-directive advice about unsubsidised high-cost drugs and for offering different forms of hope in the context of treatment failure. Implementing small organisational changes - such as reducing interruptions during consultations and informing patients of the duration of their allocated consultation - may also help reduce stressful practice situations.
authors.affiliation: University of Sydney, Sydney, NSW, Australia. adimoska@psy.unsw.edu.au
authors.forename: Aneta
authors.initials: A
authors.lastname: Dimoska
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
authors.forename: Vibeke
authors.initials: V
authors.lastname: Hansen
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.forename: Martin H N
authors.initials: MH
authors.lastname: Tattersall
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001315:Australia; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D012017:Referral and Consultation; D012737:Sex Factors; D013038:Specialization; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014342:Truth Disclosure