Communicating Oncologic Prognosis With Empathy: A Pilot Study of a Novel Communication Guide

Abstract

Background: Clear communication between patients, families, and health-care providers is imperative to maximize patient outcomes, particularly for patients diagnosed with incurable cancer who require prompt engagement in decision-making. In response to the need to engage in quality patient-centered communication, an interprofessional team, representing medicine, nursing, social work, spiritual care, and clinical psychology, explored extant literature and developed a simple, single-page communication guide that summarizes the prognosis for patients with incurable cancers. The tool was specifically designed to enhance communication for patients, families, and across all members of the treatment and patient support team.

Purpose: The purpose of this pilot study was to evaluate the impact of the communication guide on patient's accurate understanding of prognosis and the feasibility and acceptability of the intervention.

Methods: The study employed a sequential explanatory mixed-method design. Using pre- and post-tests, participants completed a prognosis and treatment perception survey and were randomized into control or intervention groups based on preference for prognostic information. The oncologist utilized the communication guide with the participants in the intervention group. Finally, 6-week post-test surveys were completed, followed by an exit interview.

Results: Key findings revealed participants prefer receiving detailed information about prognosis and have differing perceptions compared to the oncologists. Understandings of prognosis for patients and oncologists became more congruent following use of the communication guide. Participants found the tool useful and helpful.

Conclusions: The communication tool serves as a promising mechanism to enhance patient-centered communication about prognosis for patients with incurable cancer.

Keywords: cancer care; communication; interprofessional care; oncology; prognosis; therapeutic communication.