How oncologists and their patients with advanced cancer communicate about health-related quality of life.
OBJECTIVE
To describe the content and frequency of communication about health-related quality of life (HRQOL) during outpatient encounters between oncologists and their patients with advanced cancer.


METHODS
We coded for HRQOL talk in a subset of audio-recorded conversations (each previously found to contain prognostic talk by the oncologist) from the Study of Communication in Oncologist-Patient Encounters Trial, a randomized controlled trial conducted from 2003 to 2008 in two large US academic medical centers and one Veterans Affairs Medical Center.


RESULTS
Seventy-three encounters involved 70 patients and 37 oncologists. Patients were more likely to be female (53%), White (86%), married (78%), and possessing some college education (62%). Most oncologists were male (78%) and White (78%). Mean ages were 59 years for patients and 44 years for oncologists. Every encounter included some talk about HRQOL and HRQOL discussions made up, on average, 25% of the visit time. HRQOL segments described symptoms (50%), general HRQOL (27%), and the following concerns: physical (27%), functional (22%), psychological (9%), social (7%), spiritual (1%), and other (28%). Topics included treatment (56%), disease (14%), and testing (3%), and conversations focused on past (44%), present (68%), and future HRQOL (59%).


CONCLUSIONS
HRQOL discussions between oncologists and patients are common, but the emphasis is often on treatment (e.g. side effects) and symptoms (e.g. pain) even in patients with advanced disease. Given the often intense emotional experience of patients with advanced cancer, oncologists may need to pay more attention to psychological, social, and spiritual HRQOL concerns.
Rodriguez
Keri L
KL
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA. Keri.rodriguez@va.gov
Bayliss
Nichole
N
Alexander
Stewart C
SC
Jeffreys
Amy S
AS
Olsen
Maren K
MK
Pollak
Kathryn I
KI
Kennifer
Sarah L
SL
Tulsky
James A
JA
Arnold
Robert M
RM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003142:Communication; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology* / Q000523:psychology*; D010817:Physician-Patient Relations; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires