title: When cure is no option: how explicit and hopeful can information be given? A qualitative study in breast cancer.
abstract: OBJECTIVE
  To investigate how oncologists can balance explicit with general and realistic with hopeful information when discussing various topics at the transition from curative to palliative care in breast cancer.
  
  
  METHODS
  Qualitative analysis of focus groups consisting of female breast cancer survivors and healthy women.
  
  
  RESULTS
  Perceptions of survivors and healthy women largely overlapped. Participants thought that oncologists can help patients regain a future perspective during this consultation. To achieve this, four themes seemed important: honest medical information, availability of continued support, hope has many faces, and space to choose. Moreover, participants stressed they would need time to let the message sink in before any further information was provided.
  
  
  CONCLUSIONS
  Participants thought that when confronted with this type of consultation they would need - more or less explicit - medical information and information regarding support. In order to maintain hope, knowledge about (treatment) possibilities is important, but also the certainty not to be abandoned by the hospital at a later stage of the disease and the confidence to remain able to make one's own decisions.
  
  
  CONCLUSIONS
  A life-limiting diagnosis may shatter patients' future perspective; however, this study provides suggestions for oncologists to create a new perspective.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands. l.vanvliet@nivel.nl
authors.forename: Liesbeth
authors.initials: L
authors.lastname: van Vliet
authors.forename: Anneke
authors.initials: A
authors.lastname: Francke
authors.forename: Samanta
authors.initials: S
authors.lastname: Tomson
authors.forename: Nicole
authors.initials: N
authors.lastname: Plum
authors.forename: Elsken
authors.initials: E
authors.lastname: van der Wall
authors.forename: Jozien
authors.initials: J
authors.lastname: Bensing
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D012944:Social Support; D017741:Survivors / Q000523:psychology*; D013727:Terminal Care / Q000523:psychology*