title: How oncologists communicate information to women with recurrent ovarian cancer in the context of treatment decision making in the medical encounter.
abstract: BACKGROUND
  Women with recurrent ovarian cancer depend on their physicians to provide them with information about their diagnosis and available treatment options if they wish to participate in the process of choosing the treatment. There is no information on how oncologists give information to women during the physician-patient encounter at the time the disease recurs.
  
  
  OBJECTIVE
  To explore from the oncologists' perspective (i) the extent to which oncologists provide their own patients who are experiencing their first recurrence of ovarian cancer with the same information about management options, and (ii) any explicit or implicit criteria they use to decide whether and how to tailor the information to individual patients.
  
  
  METHODS
  We adopted a qualitative, exploratory descriptive approach to begin to understand oncologists' perspectives on how they gave information to patients within the context of their clinical practice. Individual interviews were used to identify themes related to the study objectives.
  
  
  RESULTS
  Fifteen gynaecologic and five medical oncologists participated. Theme 1 describes the extent to which oncologists give information to their patients in the same way or in different ways. This section describes how the same oncologist may modify the depth of information transfer based on several factors. Theme 2 focuses on the factors that influence what information is given. For example, the amount and type of information given is based on the oncologist's on-going assessment of how the patient is assimilating the information shared during the medical encounter, the oncologists' perception of their relationship with the patient and the oncologist's assessment of what role they should take in decision making. Theme 3 involves the factors that influenced how information is given. For example, the information shared may vary based on the oncologist's perception of the patient's vitality, the patient's comprehension of the information, the patient's emotional well-being. In addition, the oncologist may make the information relevant for the patient by using analogies. Different types of information may be shared based on the oncologist's perception of patient- or family-initiated question. The information relay may be curtailed based on competing demands for the oncologist.
  
  
  CONCLUSIONS
  Oncologists provide women with information on their disease status, their treatment options and the side effects of treatment. The oncologists use perceptions to determine what information and how to provide information. The question this paper raises is whether the oncologist's perceptions reflect the individual patient's information and decision-making needs.
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: Lorraine M
authors.initials: LM
authors.lastname: Elit
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: Cathy
authors.initials: C
authors.lastname: Charles
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
authors.affiliation: University of Waterloo, Waterloo, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ranford
authors.affiliation: Core Research and Consulting, Ottawa, ON, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Tedford-Gold
authors.affiliation: Association of Faculties of Medicine of Canada, Ottawa, ON, Canada.
authors.forename: Irving
authors.initials: I
authors.lastname: Gold
mesh_terms: D003142:Communication; D003657:Decision Making; D005260:Female; D006176:Gynecology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008495:Medical Oncology; D009364:Neoplasm Recurrence, Local / Q000523:psychology / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team; D010817:Physician-Patient Relations; D036301:Qualitative Research
keywords: information giving; oncologist perspective; ovarian cancer; qualitative