The duality of option-listing in cancer care

•Listing treatment choices, termed option-listing (OL) can facilitate SDM.•In early disease, we find OL can constrain patient choice via physician preference.•In advanced disease, we find options get presented without physician preference.•OL can foster patient realization that options are diminishi...

Full description

Saved in:
Bibliographic Details
Published in:Patient education and counseling 2020-01, Vol.103 (1), p.71-76
Main Authors: Tate, Alexandra, Rimel, B.J.
Format: Article
Language:English
Subjects:
Communication
Conversation analysis
Decision Making
Doctor-patient communication
Humans
Neoplasms - therapy
Oncologists
Oncology
Patient Participation
Physician-Patient Relations
Physicians
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•Listing treatment choices, termed option-listing (OL) can facilitate SDM.•In early disease, we find OL can constrain patient choice via physician preference.•In advanced disease, we find options get presented without physician preference.•OL can foster patient realization that options are diminishing beyond a cure. Listing more than one option for treatment, termed “option-listing” (OL) is one way to facilitate shared decision-making. We seek to evaluate how oncologists do option-listing in clinical encounters across disease contexts. We coded and transcribed 90 video-recorded interactions between 5 oncologist participants and a convenience sample of 82 patients at 2 large clinics in the western U.S. We used conversation analytic (CA) methods to examine patterns of behavior when oncologists provided more than one treatment option to patients. In early-stage disease, OL provides patients with options while at the same time constraining those options through expression of physician bias. This effect disappears when cancer is at an advanced stage. In this context, OL is presented without physician preference and demonstrates recission of medical authority. In early-stage contexts, OL functions as a way for physicians to array available options to patients while also communicating their expertise. In advanced-stage contexts, OL functions as a way to minimize treatment options and highlight dwindling possibilities. OL is one way to implement shared decision-making, but it can also be used to facilitate a realization that treatment choices are diminishing and disease is progressing beyond a cure.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2019.07.025