title: Beyond good intentions and patient perceptions: competing definitions of effective communication in head and neck cancer care at the end of life.
abstract: Effective communication between dying cancer patients and their health care providers about prognosis and treatment options ensures informed decision making at the end of life. This study analyzed data from interviews with end-stage head and neck cancer patients and their health care providers about communication competence and approaches to communicating about end-of-life issues. Patients rated their oncologists as competent and comfortable discussing end-of-life issues, although few reported discussing specific aspects of end-of-life care. Oncologists viewed giving prognostic information as a process rather than a singular event, and preferred answering patients' questions as opposed to guiding the discussion. These data reveal subtle disconnects in communication suggesting that patients' and health care providers' information needs are not being met.
authors.affiliation: Department of Communication, University of South Florida, Tampa, FL 33620-7800, USA. lroscoe@usf.edu
authors.forename: Lori A
authors.initials: LA
authors.lastname: Roscoe
authors.forename: Jillian A
authors.initials: JA
authors.lastname: Tullis
authors.forename: Richard R
authors.initials: RR
authors.lastname: Reich
authors.forename: Judith Czaja
authors.initials: JC
authors.lastname: McCaffrey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D058015:Health Communication / Q000379:methods / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D013727:Terminal Care