title: Dumping the information bucket: A qualitative study of clinicians caring for patients with early stage non-small cell lung cancer.
abstract: To evaluate the quality of patient-clinician communication and shared decision making (SDM) when two disparate treatments for early stage non-small cell lung cancer (NSCLC) are discussed.
  
  
  
  We conducted a qualitative study to evaluate the experiences of 20 clinicians caring for patients with clinical Stage I NSCLC prior to treatment, focusing on communication practices. We used directed content analysis and a patient-centered communication theoretical model to guide understanding of communication strategies.
  
  
  
  All clinicians expressed the importance of providing information, especially for mitigating patient worry, despite recognition that patients recall only a small amount of the information given. When patients expressed distress, clinicians exhibited empathy but preferred to provide more information in order to address patient concerns. Most clinicians reported practicing SDM, however, they also reported not clearly eliciting patient preferences and values, a key part of SDM.
  
  
  
  Communication with patients about treatment options for early stage NSCLC primary includes information giving. We found that only a few communication domains associated with SDM occurred regularly, and SDM may not be necessary in this clinical context.
  
  
  
  Clinicians may need to incorporate nurse navigators or more written materials for effectively discussing potentially equivalent treatment options with their patients.
authors.affiliation: Health Services Research & Development, VA Portland Health Care System, Portland, OR, USA. Electronic address: sara.golden1@va.gov.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Golden
authors.affiliation: Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA. Electronic address: thomasch@ohsu.edu.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Thomas
authors.affiliation: Radiation Oncology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA; Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: dmoghanaki@vcu.edu.
authors.forename: Drew
authors.initials: D
authors.lastname: Moghanaki
authors.affiliation: Health Services Research & Development, VA Portland Health Care System, Portland, OR, USA; Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Department of Medicine, Oregon Health & Science University, Portland, OR, USA; Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System; Portland, OR, USA. Electronic address: christopher.slatore@va.gov.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Slatore
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology* / Q000628:therapy; D003142:Communication; D003657:Decision Making; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008175:Lung Neoplasms / Q000523:psychology* / Q000628:therapy; D008297:Male; D008962:Models, Theoretical; D010358:Patient Participation; D057240:Patient Preference; D010817:Physician-Patient Relations; D036301:Qualitative Research; D013315:Stress, Psychological; D014481:United States
keywords: Communication; Patient-centered outcomes; Thoracic diseases