title: Improving consultations in oncology: the development of a novel consultation aid.
abstract: BACKGROUND
  The way in which patients receive bad news in a consultation can have a profound effect in terms of anxiety, depression and subsequent adjustment. Despite investment in well-researched communication skills training and availability of decision-making aids, communication problems in oncology continue to be encountered.
  
  
  METHODS
  We conducted a mixed-methods study in a large UK Cancer Centre to develop a novel consultation aid that could be used jointly by patients and doctors. Consultations were audio-recorded and both the doctors and the patients were interviewed. We used conversation analysis to analyse the consultation encounter and interpretative phenomenological analysis to analyse the interviews. Key themes were generated to inform the design of the aid.
  
  
  RESULTS
  A total of 16 doctors were recruited into the study along with 77 patients. Detailed analysis from 36 consultations identified key themes (including preparation, information exchange, question-asking and decision making), which were subsequently addressed in the design of the paper-based aid.
  
  
  CONCLUSIONS
  Using detailed analysis and observation of oncology consultations, we have designed a novel consultation aid that can be used jointly by doctors and patients. It is not tumour-site specific and can potentially be utilised by new and follow-up consultations.
authors.affiliation: Department of Cancer Studies and Molecular Medicine, Osborne Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
authors.forename: L
authors.initials: L
authors.lastname: Furber
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK.
authors.forename: G M
authors.initials: GM
authors.lastname: Murtagh
authors.affiliation: Department of Clinical Psychology, University of Leicester, Leicester LE1 9HN, UK.
authors.forename: S A
authors.initials: SA
authors.lastname: Bonas
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester LE1 6TP, UK.
authors.forename: J G
authors.initials: JG
authors.lastname: Bankart
authors.affiliation: Department of Cancer Studies and Molecular Medicine, Osborne Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
authors.forename: A L
authors.initials: AL
authors.lastname: Thomas
mesh_terms: D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000458:organization & administration* / Q000592:standards