Exploring symptom meaning: perspectives of palliative care physicians
- 347 Downloads
Understanding patients’ symptom experiences is essential to providing effective clinical care. The discussion between patients and physicians of symptom meaning and its significance, however, is ill understood.
To investigate palliative care physicians’ understanding of symptom meaning, and their experiences of and attitudes towards the discussion of symptom meaning with patients.
Semi-structured interviews were conducted (N = 17) across Sydney, Australia. Transcripts were analysed using framework analysis.
Six key themes were identified: (1) definitions of symptom meaning (causal meanings, functional impact, existential impact, and cascade of meanings); (2) meanings are personal (demographic, culture, spiritual, and family differences); (3) eliciting meanings requires subtlety and trust (following the patient’s cues); discussing meaning can be (4) hard (for the patient and health professional); (5) therapeutic (assuaging fears, feeling listened to and valued, increased sense of control, and reduced symptom distress); and (6) enhances clinicians’ practice and work satisfaction (provision of more tailored care, reassurance through the provision of information, and strengthening of doctor-patient relationship).
Exploring symptom meaning can serve to provide information, alleviate anxiety, and facilitate individualised care, but only when patients present cues or are open to discuss symptom-related concerns. However, various barriers hinder such dialogue in consultations. Greater awareness of symptom meaning and its influence may facilitate physicians exploring symptom meaning more with patients in the future.
KeywordsSymptom meaning Symptom experience Palliative care Advanced cancer Qualitative research Health professionals
Compliance with ethical standards
The University of Sydney Human Research Ethics Committee granted approval for this study.
Conflict of interest
The authors declare that they have no conflicts of interest.
- 7.Cancer Council Australia (2017) Cancer pain management in adults. http://wiki.cancer.org.au/australia/Guidelines:Cancer_pain_management. Accessed March 2, 2017
- 17.Liamputtong P (2013) Qualitative research methods, 4th edn. Oxford University Press, MelbourneGoogle Scholar
- 18.Shuy RW (2003) In-person versus telephone interviewing. In: Holstein JA, Gubrium JF (eds) Inside interviewing: new lenses, new concerns. Sage Publications Inc, Thousand Oaks, pp 174–193Google Scholar
- 28.Butow P, Cockburn J, Girgis A, Bowman D, Schofield P, D'Este C, Stojanovski E, Tattersall MHN, the CUES Team (2008) Increasing oncologists’ skills in eliciting and responding to emotional cues: evaluation of a communication skills training program. Psychooncology 17:209–218CrossRefPubMedGoogle Scholar