When cure is no option: How explicit and hopeful can information be given? A qualitative study in breast cancer

• Published in: Patient education and counseling 2013-03, Vol.90 (3), p.315-322
• Main Authors: van Vliet, Liesbeth, Francke, Anneke, Tomson, Samanta, Plum, Nicole, van der Wall, Elsken, Bensing, Jozien
• Format: Article
• Language: English
• Subjects: Adult; Aged; Breast cancer; Breast Neoplasms - psychology; Case-Control Studies; Clinical information; Communication; Consultation; Female; Focus Groups; Humans; Internal Medicine; Middle Aged; Nursing; Oncologists; Palliative care; Patient preference; Physician-Patient Relations; Social Support; Survivors; Survivors - psychology; Terminal Care - psychology; Truth disclosure; Women
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2011.03.021

Abstract Objective To investigate how oncologists can balance explicit with general and realistic with hopeful information when discussing various topics at the transition from curative to palliative care in breast cancer. Methods Qualitative analysis of focus groups consisting of female breast cancer survivors and healthy women. Results Perceptions of survivors and healthy women largely overlapped. Participants thought that oncologists can help patients regain a future perspective during this consultation. To achieve this, four themes seemed important: honest medical information, availability of continued support, hope has many faces, and space to choose. Moreover, participants stressed they would need time to let the message sink in before any further information was provided. Conclusion Participants thought that when confronted with this type of consultation they would need – more or less explicit – medical information and information regarding support. In order to maintain hope, knowledge about (treatment) possibilities is important, but also the certainty not to be abandoned by the hospital at a later stage of the disease and the confidence to remain able to make one's own decisions. Practice implications A life-limiting diagnosis may shatter patients’ future perspective; however, this study provides suggestions for oncologists to create a new perspective.