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Behind closed doors II: systematic analysis of prostate cancer patients' primary treatment consultations with radiation oncologists and predictors of satisfaction with communication
Author(s) -
Hack Thomas F.,
Ruether J. Dean,
Pickles Tom,
Bultz Barry D.,
Chateau Dan,
Degner Lesley F.
Publication year - 2012
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.1984
Subject(s) - psychosocial , medicine , anxiety , family medicine , distress , patient satisfaction , prostate cancer , radiation oncologist , cancer , clinical psychology , nursing , psychiatry , radiation therapy
Objective The purpose of this investigation was to explicate the content of primary treatment consultations in prostate oncology and examine the predictive relationships between patient, significant other, and oncologist consultation factors and patient satisfaction with communication. Methods The recorded consultations of 156 newly diagnosed prostate cancer patients from three Canadian cancer centers were examined using the Medical Interaction Process System (MIPS). The MIPS findings, independent observer ratings of patient, significant other, and oncologist affective behavior, and derived consultation ratios of patient centeredness, patient directedness, and psychosocial focus, were used to predict patient satisfaction with communication post‐consultation and at 12‐weeks post‐consultation. Results Biomedical content categories were predominant in the consultations, accounting for 86% of utterances, followed by administrative (9%) and psychosocial (5%) utterances. Post‐consultation satisfaction with communication was significantly lower for patients whose significant others were rated as more assertive during the consultation, and those rated as more anxious during the consultation. Patients who were rated as more anxious during the consultation, those with lower satisfaction with communication immediately post‐consultation and those with shorter consultations were significantly less satisfied with communication at 12‐weeks post‐consultation. Conclusions Adjuvant treatment consultations in prostate oncology are characterized by a high degree of information‐giving by the physician, a predominance of biomedical discussion, and relatively minimal time addressing patients' psychosocial concerns. Patients may benefit from oncologists who address anxiety and emotional distress during the primary treatment consultation, allowing sufficient time to ensure that patients leave the consultation with their communication needs having been satisfied. Copyright © 2011 John Wiley & Sons, Ltd.