TY - JOUR
T1 - Patient-provider communication during second opinion consultations in oncology
AU - Lehmann, Vicky
AU - Smets, Ellen M. A.
AU - de Jong, Maxime
AU - de Vos, Filip Y. F.
AU - Stouthard, Jacqueline M.
AU - Hillen, Marij A.
N1 - Funding Information: This work was supported by a personal grant from the Dutch Cancer Society [KWF Kankerbestrijding] (Hillen, UVA2014-6671). All authors, apart from F.Y.F. de Vos, declare no conflict of interest. Dr. de Vos received personal grants from Roche and AbbVie, which are however independent of this work. Publisher Copyright: © 2021 The Authors
PY - 2021/10
Y1 - 2021/10
N2 - Objective: Providing a second opinion (SO) in oncology is complex, and communication during SOs remains poorly understood. This study aimed to systematically observe how patients and oncologists communicate about SO-specific topics (i.e., patient motivation, the referring oncologist, treatment transfer/back-referral), and how such communication affects patient satisfaction. Methods: A prospective mixed-methods study of cancer patients seeking a SO (N = 69) and consulting oncologists was conducted. Before the SO, patients reported their expected place of future treatment. Following the SO, patients’ and oncologists’ satisfaction was assessed. All SOs were audio-recorded. Absolute and relative duration of SO-specific talk were calculated and specific events (e.g., questions/utterances) were coded (incl. valence, explicitness). Results: SOs lasted 19–73 min, of which 3.7% was spent discussing motivations. Oncologists rarely explored patients’ motivations. Talk about referring oncologists (12.5% of consultation) was mostly critical by patients (M = 43.0%), but positive/confirming by consulting oncologists (M = 73.5%). Although 22.2% of patients expected a treatment transfer, this topic (3.3% of consultation time) was rarely explicitly discussed. Patients who were referred back were significantly less satisfied (d = 0.85). Conclusion: Patient-provider communication in oncological SOs appears insufficiently aligned. Practice Implications: Patients and oncologists need support to explicitly and productively communicate about SO-specific topics and to better manage expectations. Recommendations are provided.
AB - Objective: Providing a second opinion (SO) in oncology is complex, and communication during SOs remains poorly understood. This study aimed to systematically observe how patients and oncologists communicate about SO-specific topics (i.e., patient motivation, the referring oncologist, treatment transfer/back-referral), and how such communication affects patient satisfaction. Methods: A prospective mixed-methods study of cancer patients seeking a SO (N = 69) and consulting oncologists was conducted. Before the SO, patients reported their expected place of future treatment. Following the SO, patients’ and oncologists’ satisfaction was assessed. All SOs were audio-recorded. Absolute and relative duration of SO-specific talk were calculated and specific events (e.g., questions/utterances) were coded (incl. valence, explicitness). Results: SOs lasted 19–73 min, of which 3.7% was spent discussing motivations. Oncologists rarely explored patients’ motivations. Talk about referring oncologists (12.5% of consultation) was mostly critical by patients (M = 43.0%), but positive/confirming by consulting oncologists (M = 73.5%). Although 22.2% of patients expected a treatment transfer, this topic (3.3% of consultation time) was rarely explicitly discussed. Patients who were referred back were significantly less satisfied (d = 0.85). Conclusion: Patient-provider communication in oncological SOs appears insufficiently aligned. Practice Implications: Patients and oncologists need support to explicitly and productively communicate about SO-specific topics and to better manage expectations. Recommendations are provided.
KW - Communication
KW - Oncology
KW - Physician-patient relations
KW - Referral and consultation
KW - Second opinions
UR - http://www.scopus.com/inward/record.url?scp=85102730538&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.pec.2021.03.011
DO - https://doi.org/10.1016/j.pec.2021.03.011
M3 - Article
C2 - 33744055
SN - 0738-3991
VL - 104
SP - 2490
EP - 2497
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 10
ER -