Oncologists’ experience with discussing cancer prognosis with patients and families: perspectives from India

Maya, Sravannthi and Banerjee, Smita C and Chawak, Shweta and Parker, Patricia A and Kandikattu, Sreekanth and Chittem, Mahati (2021) Oncologists’ experience with discussing cancer prognosis with patients and families: perspectives from India. Translational Behavioral Medicine, 11 (10). pp. 1896-1904. ISSN 1869-6716

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Nondisclosure of prognosis of advanced cancer is commonly practiced in some Asian cultures including India; but research is limited. To describe experiences of Indian oncologists in discussing cancer prognosis with people with cancer and their caregivers, with a focus on barriers and facilitators of prognostic discussions. Thirty oncologists practicing in South India, Hyderabad participated in semi-structured interviews; and analyzed using Interpretative Phenomenological Analysis. Barriers included system-level, patient-level, and physician-level challenges as obstructions to open and honest interactions around cancer prognosis. Most of the barriers focused on communication-related challenges. Lack of communication skills training for providers coupled with over-reliance on use of euphemisms, hesitation in communicating with "weak" patient, and struggles to establish healthcare proxy described communication-related barriers. The study also described factors including family involvement in cancer care and empathic communication as facilitators of honest and open communication about prognosis. In particular, rapport building and getting to know the patient, use of empathic communication, engaging in gradual and individualized disclosure, and balancing hope with honesty were communication-related facilitators that aid open communication with patients with cancer and their caregivers about prognosis and plan of care. Results provide implications for development of communication skills trainings for oncology physicians in India. Adapting, delivering, and evaluating existing communication skills training programs, particularly around discussions of prognosis and goals of care is a requisite step for providing patient-centered and supportive care to patients with cancer and their caregiving families. © 2021 Oxford University Press. All rights reserved.

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IITH Creators:
IITH CreatorsORCiD
Chittem, MahatiUNSPECIFIED
Item Type: Article
Uncontrolled Keywords: Cancer; Communication skills training; Disclosure; Oncologists; Prognosis
Subjects: Arts > Liberal arts
Divisions: Department of Liberal Arts
Depositing User: . LibTrainee 2021
Date Deposited: 12 Sep 2022 09:19
Last Modified: 12 Sep 2022 09:19
URI: http://raiith.iith.ac.in/id/eprint/10542
Publisher URL: http://doi.org/10.1093/tbm/ibab070
OA policy: https://v2.sherpa.ac.uk/id/publication/34746
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