Physician communication styles in initial consultations for hematological cancer

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• 作者：Karan R. Chhabra ; Kathryn I. Pollak ; Stephanie J. Lee ; Anthony L. Back ; Roberta E. Goldman ; James A. Tulsky
• 关键词：US ; Physician&ndash ; patient communication ; Oncology consultations ; Information delivery ; Patient participation ; Shared decision-making ; Physician&ndash ; patient relationships ; Second opinions
• 刊名：Patient Education and Counseling
• 出版年：December, 2013
• 年：2013
• 卷：93
• 期：3
• 页码：573-578
• 全文大小：305 K

文摘

Objective

To characterize practices in subspecialist physicians鈥?communication styles, and their potential effects on shared decision-making, in second-opinion consultations.

Methods

Theme-oriented discourse analysis of 20 second-opinion consultations with subspecialist hematologist-oncologists.

Results

Physicians frequently 鈥渂roadcasted鈥?information about the disease, treatment options, relevant research, and prognostic information in extended, often-uninterrupted monologs. Their communicative styles had one of two implications: conveying options without offering specific recommendations, or recommending one without incorporating patients鈥?goals and values into the decision. Some physicians, however, used techniques that encouraged patient participation.

Conclusions

Broadcasting may be a suboptimal method of conveying complex treatment information in order to support shared decision-making. Interventions could teach techniques that encourage patient participation.

Practice implications

Techniques such as open-ended questions, affirmations of patients鈥?expressions, and pauses to check for patient understanding can mitigate the effects of broadcasting and could be used to promote shared decision-making in information-dense subspecialist consultations.