Open AccessClinicians’ communication with patients receiving a MCI diagnosis: The ABIDE project
Author(s) -
Leonie N. C. Visser,
Ingrid S. van Maurik,
Femke H. Bouwman,
Salka S. Staekenborg,
Ralph Vreeswijk,
Liesbeth Hempenius,
Marlijn H. de Beer,
Gerwin Roks,
Leo Boelaarts,
Mariska Kleijer,
Wiesje M. van der Flier,
Ellen M. A. Smets
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0227282
Subject(s) - medicine , dementia , thematic analysis , medline , advance care planning , conversation , cognition , health care , intensive care medicine , family medicine , disease , psychiatry , psychology , nursing , qualitative research , pathology , palliative care , social science , communication , sociology , political science , law , economics , economic growth
Background We aimed to explore clinicians’ communication, including the discussion of diagnosis, cause, prognosis and care planning, in routine post-diagnostic testing consultations with patients with Mild Cognitive Impairment (MCI). Methods Thematic content analysis was used to analyze audiotaped consultations in which 10 clinicians (eight neurologists and two geriatricians) from 7 memory clinics, disclosed diagnostic information to 13 MCI patients and their care partners. We assessed clinician-patient communication regarding diagnostic label, cause, prognosis and care planning to identify core findings. Results Core findings were: clinicians 1) differed in how they informed about the MCI label; 2) tentatively addressed cause of symptoms; 3) (implicitly) steered against further biomarker testing; 4) rarely informed about the patient’s risk of developing dementia; 5) often informed about the expected course of symptoms emphasizing potential symptom stabilization and/or improvement, and; 6) did not engage in a conversation on long-term (care) planning. Discussion Clinicians’ information provision about the underlying cause, prognosis and implications for long-term (care) planning in MCI could be more specific. Since most patients and care partners have a strong need to understand the patient’s symptoms, and for information on the prognosis and implications for the future, clinicians’ current approach may not match with those needs.