title: Patient perceptions of oncologist-patient communication about prognosis: changes from initial diagnosis to cancer recurrence.
abstract: Cancer recurrence presents oncologists with many challenges, including discussing prognosis. A thematic analysis of patient interviews was conducted to learn more about how this challenge is met by doctors and patients in their communication. Female patients being treated for a cancer recurrence at a comprehensive cancer center (N = 30) were asked to recall how they discussed their prognosis with oncologists when initially diagnosed and when the cancer recurred. All interviews were recorded, transcribed, and thematic analysis applied to patients' remarks concerning prognosis. Following comparison of prognosis quotes identified in the transcript, two primary themes were drawn from the data: communicating optimism at the initial diagnosis; and communicating chronic disease management at recurrence. Three subthemes were also identified in the recurrence communication: managing the new information; ambiguous communication about the prognosis; and the information seeking paradox. Problematic integration theory is offered as an important explanatory mechanism for understanding oncologist-patient communication about prognosis during a cancer recurrence.
authors.affiliation: Department of Family Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. mary.step@case.edu
authors.forename: Mary M
authors.initials: MM
authors.lastname: Step
authors.forename: Eileen Berlin
authors.initials: EB
authors.lastname: Ray
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002908:Chronic Disease / Q000523:psychology*; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008495:Medical Oncology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D010817:Physician-Patient Relations; D011379:Prognosis; D012008:Recurrence; D012938:Social Perception