Patient-physician communication about early stage prostate cancer

Analysis of overall visit structure

Stephen G Henry, Danielle Czarnecki, Valerie C. Kahn, Wen Ying Sylvia Chou, Angela Fagerlin, Peter A. Ubel, David R. Rovner, Stewart C. Alexander, Sara J. Knight, Margaret Holmes-Rovner

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: We know little about patient-physician communication during visits to discuss diagnosis and treatment of prostate cancer. Objective: To examine the overall visit structure and how patients and physicians transition between communication activities during visits in which patients received new prostate cancer diagnoses. Participants: Forty veterans and 18 urologists at one VA medical centre. Methods: We coded 40 transcripts to identify major communication activities during visits and used empiric discourse analysis to analyse transitions between activities. Results: We identified five communication activities that occurred in the following typical sequence: 'diagnosis delivery', 'risk classification', 'options talk', 'decision talk' and 'next steps'. The first two activities were typically brief and involved minimal patient participation. Options talk was typically the longest activity; physicians explicitly announced the beginning of options talk and framed it as their professional responsibility. Some patients were unsure of the purpose of visit and/or who should make treatment decisions. Conclusion: Visits to deliver the diagnosis of early stage prostate cancer follow a regular sequence of communication activities. Physicians focus on discussing treatment options and devote comparatively little time and attention to discussing the new cancer diagnosis. Towards the goal of promoting patient-centred communication, physicians should consider eliciting patient reactions after diagnosis delivery and explaining the decision-making process before describing treatment options.

Original languageEnglish (US)
Pages (from-to)1757-1768
Number of pages12
JournalHealth Expectations
Volume18
Issue number5
DOIs
StatePublished - Oct 1 2015

Fingerprint

Prostatic Neoplasms
Communication
Physicians
Patient Participation
Patient Transfer
Veterans
Therapeutics
Decision Making
Neoplasms

Keywords

  • Discourse analysis
  • Patient-centred communication
  • Prostate cancer
  • Qualitative research
  • Structure
  • Transitions
  • Veterans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Henry, S. G., Czarnecki, D., Kahn, V. C., Chou, W. Y. S., Fagerlin, A., Ubel, P. A., ... Holmes-Rovner, M. (2015). Patient-physician communication about early stage prostate cancer: Analysis of overall visit structure. Health Expectations, 18(5), 1757-1768. https://doi.org/10.1111/hex.12168

Patient-physician communication about early stage prostate cancer : Analysis of overall visit structure. / Henry, Stephen G; Czarnecki, Danielle; Kahn, Valerie C.; Chou, Wen Ying Sylvia; Fagerlin, Angela; Ubel, Peter A.; Rovner, David R.; Alexander, Stewart C.; Knight, Sara J.; Holmes-Rovner, Margaret.

In: Health Expectations, Vol. 18, No. 5, 01.10.2015, p. 1757-1768.

Research output: Contribution to journalArticle

Henry, SG, Czarnecki, D, Kahn, VC, Chou, WYS, Fagerlin, A, Ubel, PA, Rovner, DR, Alexander, SC, Knight, SJ & Holmes-Rovner, M 2015, 'Patient-physician communication about early stage prostate cancer: Analysis of overall visit structure', Health Expectations, vol. 18, no. 5, pp. 1757-1768. https://doi.org/10.1111/hex.12168
Henry, Stephen G ; Czarnecki, Danielle ; Kahn, Valerie C. ; Chou, Wen Ying Sylvia ; Fagerlin, Angela ; Ubel, Peter A. ; Rovner, David R. ; Alexander, Stewart C. ; Knight, Sara J. ; Holmes-Rovner, Margaret. / Patient-physician communication about early stage prostate cancer : Analysis of overall visit structure. In: Health Expectations. 2015 ; Vol. 18, No. 5. pp. 1757-1768.
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