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Information Needs Expressed During Patient-Oriented Oncology Consultations: Quantity, Variation, and Barriers

  • Anesa Ahamad
  • Paul Wallner
  • Sharon Salenius
  • Rudi Ross
  • Eduardo Fernandez
Article

Abstract

High-quality oncology consultation includes patient-oriented communication tailored to patients’ individualized needs. Common methods used in studies to increase question-asking are prompt lists and coaching pre-consultations. However, our patients were encouraged to ask questions by the physician during their visit. We aimed to estimate the quantity, nature, and variation of their questions when they were invited to ask by their oncologist. During radiotherapy consultations from 2012 to 2016, patient’s questions were deliberately elicited and physician-transcribed. We derived mean and median number of questions per patient, variance by patient factors, and a taxonomy of subjects using thematic analysis. Three hundred ninety-six patients asked 2386 questions, median asked per patient = 6 (interquartile range = 4). We found significant variance with age (mean = 6.9 questions for < 60 years, 5.4 for ≥ 70 years) p = 0.018, insurance type (mean = 4.7 for Medicaid, 7.2 for private insurance) p = 0.0004, and tumor site (mean number of questions: skin = 4.6, lymphoma = 5.2, lung = 5.8, breast = 6.1, prostate = 6.3, rectum = 6.7 head and neck = 6.9, brain = 7.0, bladder = 7.2, anus = 8.8, others = 5.8) p = 0.0440. Of the diverse set of 57 topics, the commonest were 1. logistics, 2. radiotherapy details, 3. side effects, 4. diagnosis, and 5. stage and prognosis. Only 17 topics were asked by more > 10% of patients and 40 topics were asked by < 10% of patients. With median of 6 questions, it is practicable to routinely elicit and address individualized information needs. Potential barriers may be older and underinsured patients. The wide variety of topics, often pertaining to individuals’ case, suggests that cancer clinicians should take time-out during consultation to elicit patients’ questions to accomplish best-practice communication.

Keywords

Cancer Oncology Communication Patient-oriented communication Radiotherapy Personalized medicine Nature of information needs Quantity of information need Patient-reported information needs Variation of information needs Patient-centered communication Frequently asked radiotherapy questions Barriers to communication, question-asking 

Notes

Acknowledgements

We wish to thank April Mann, Writing Center Director, Senior Lecturer, College of Arts and Sciences, Department of English, University of Miami for her painstaking guidance in writing the manuscript.

An abstract of this paper in part was published at the Annual Meeting of the American Society of Clinical Oncology, 2017.

An abstract of this paper in part was presented at the Annual Meeting of the American Society of Radiation Oncology, 2017

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© American Association for Cancer Education 2018

Authors and Affiliations

  1. 1.Department of Radiation Oncology21st Century OncologyKey WestUSA
  2. 2.University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer CenterLennar Foundation Medical CenterCoral GablesUSA
  3. 3.Department of Radiation Oncology21st Century OncologyMoorestownUSA
  4. 4.Department of Research and Education21st Century OncologyFort MyersUSA
  5. 5.Department of Radiation Oncology21st Century OncologyPlantationUSA

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