Patient-centered communication and prognosis discussions with cancer patients.
OBJECTIVE
To examine physician communication associated with prognosis discussion with cancer patients.


METHODS
We conducted a study of physician-patient communication using trained actors. Thirty-nine physicians, including 19 oncologists and 20 family physicians participated in the study. Actors carried two hidden digital recorders to unannounced visits. We coded recordings for eliciting and validating patient concerns, attentive voice tone, and prognosis talk.


RESULTS
Actor adherence to role averaged 92% and the suspected detection rate was 14%. In a multiple regression, eliciting and validating patient concerns (beta=.40, C.I.=0.11-0.68) attentiveness (beta=.32, C.I.=0.06-0.58) and being an oncologist vs. a family physician (beta=.33, C.I.=0.33-1.36) accounted for 46% of the variance in prognosis communication.


CONCLUSIONS
Eliciting and validating patient concerns and attentiveness voice tone is associated with increased discussion of cancer patient prognosis as is physician specialty.


CONCLUSIONS
Eliciting and validating patient concerns and attentive voice tone may be markers of physician willingness to discuss emotionally difficult topics. Educating physicians about mindful practice may increase their ability to collect important information and to attend to patient concerns.
Shields
Cleveland G
CG
Child Development and Family Studies Department (Marriage and Family Therapy Program), Purdue University, Fowler Memorial House, 1200 W. State Street, W. Lafayette, IN 47907, USA. cgshields@purdue.edu
Coker
Casey J
CJ
Poulsen
Shruti S
SS
Doyle
Jennifer M
JM
Fiscella
Kevin
K
Epstein
Ronald M
RM
Griggs
Jennifer J
JJ
D003142:Communication; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D013223:Statistics as Topic