title: Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians.
abstract: Families are a unique source of support for many cancer patients. Most advanced communication skills training for oncologists are patient centred and do not cover interactions with family members. The current study used in-depth qualitative interviews of patients, relatives and cancer clinicians with thematic analysis to explore the role of family members in the communication process. Forty-one participants included 10 cancer patients, 10 relatives ensuring proportionate representation of both gender and primary cancer site and 21 doctors representing both medical and surgical oncology. Nineteen of 20 patients and relatives wanted an "open and honest" discussion with their doctors. All patients, relatives and doctors preferred involvement of the family at most stages of cancer treatment. Five themes were identified in relation to communication with family members. The participants highlighted the "importance of family for physical and psychological care," they emphasised the need to "balance patient autonomy and relatives desire to be protective" using varied "negotiating strategies" that are influenced by "socioeconomic circumstances of both patient and family." The doctor-patient-relative communication process was not static with preferences changing over time. The data suggests that communication skills training of cancer clinicians should incorporate modules on better communication with relatives.
authors.affiliation: Department of Palliative Care and Psycho-oncology, Tata Medical Center, Kolkata, West Bengal, India.|Gynaecological Cancer Research Centre, Institute for Women's Health, University College London, London, UK.
authors.forename: S S
authors.identifier: http://orcid.org/0000-0003-1674-5093
authors.initials: SS
authors.lastname: Datta
authors.affiliation: Department of Palliative Care and Psycho-oncology, Tata Medical Center, Kolkata, West Bengal, India.
authors.forename: L
authors.initials: L
authors.lastname: Tripathi
authors.affiliation: School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Varghese
authors.affiliation: Clare College, University of Cambridge, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Logan
authors.affiliation: Gynaecological Cancer Research Centre, Institute for Women's Health, University College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Gessler
authors.affiliation: Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India.
authors.forename: S
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Department of Gynaecological Oncology, Tata Medical Center, Kolkata, West Bengal, India.
authors.forename: J
authors.initials: J
authors.lastname: Bhaumik
authors.affiliation: Gynaecological Cancer Research Centre, Institute for Women's Health, University College London, London, UK.|Department of Gynaecological Oncology, Tata Medical Center, Kolkata, West Bengal, India.
authors.forename: U
authors.initials: U
authors.lastname: Menon
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research; D000071077:Surgical Oncology; D055815:Young Adult
keywords: cancer; communications skills; family; oncology; training