C12
‘Yours is potentially serious but most of these are cured’: optimistic communication in UK outpatient oncology consultations?
Geraldine Leydon
University of Southampton, Southampton, UK
Aim
To describe how experienced doctors discuss radiotherapy and chemotherapy with cancer patients about to undergo such treatment.
Method
Qualitative applied Conversation Analysis of 27 consultations between consultant oncologists and patients with breast, head and neck, or gastrointestinal cancer. Set in outpatient oncology clinics: one in the South West, one in the Midlands, and a large London teaching hospital. Participants included three experienced consultant oncologists and 27 patients diagnosed with cancer attending outpatient oncology consultations to discuss radiotherapy or chemotherapy.
Results
Doctors repeatedly invoked optimism when discussing bad and uncertain information about radiotherapy and chemotherapy. This was achieved by following relatively bad or uncertain information with some good information, called here the ‘Information Pairing Phenomenon’. Patients tended to collaborate in the construction of optimism by explicitly attending to relatively good tidings.
Conclusion
Doctors talked optimistically whilst sharing information about chemotherapy and radiotherapy with patients about to undergo such treatment. Research indicates that patients want their doctors to openly share bad and uncertain information, but to do so sensitively. Following uncertain or bad tidings with relatively better news was one way in which doctors delivered information honestly without diminishing opportunities for hope in the consultation room or optimism about treatment and the future. Findings from qualitative empirical studies, such as that described: (a) provide valuable information about how doctors manage the difficult task of sharing information honestly and optimistically and (b) has pedagogic potential that is complimentary to the simulated patient interactions and role play often used in communication skills training.
