LB21
What do you want to talk about? What do we talk about? The opinions of patients with head and neck (H&N) cancer on the content of medical consultations
Sheila Fisher, Aditya Vikram, Aine Donnelly, Alexander Newsham, Colin Johnston, Adam Smith, Peter Selby, Galina Velikova
University of Leeds, UK
Background
The medical consultation lies at the core of clinical care. A structure
which meets patients needs is especially important in areas where the impact
of the disease and therapy represent a significant burden.
Aim
To explore what patients would wish to be included and compare this with
their perceived content of consultations.
Method
Cross-sectional study of patients treated for H&N and thyroid cancer
and free of recurrence. Sub-groups included early oral (EO) and early larynx
(EL) patients (single modality therapy) and late groups (LO & LL)
(multimodality therapy). Data was entered on a touch-screen computer. Scoring
was on a basis of:0= not discuss, 1= discuss if the doctor mentions and 2= wish
to discuss and for content on a 1-5 Likert scale from 1=never to 5 always
mentioned.
Results
152 participants entered. Full records were achieved for 144 participants
(33 EO, 36 LO, 17 EL, 15 LL and 43 Thyroid).
Patients most wanted to discuss (79% scoring 2), physical activities affected by treatment, closely followed by symptoms and side effects of treatment (74%). These matched the perception of what was most likely to be discussed, although 24% of patients indicated that symptoms and side effects were never or rarely mentioned and 29% gave the same results for physical limitations due to the disease or its treatment.
For softer items, the gap between aspiration and perception widened. Although 61.8% of patients wished to discuss how they felt emotionally, this was perceived to be addressed almost always or often in only 11.2% of consultations. Survivorship items such as impact of cancer were seldom addressed.
Conclusion
Patients have clear views on the content of consultations. Whilst hard
medical issues are usually addressed, softer issues relating to
survivorship are less likely to be addressed.
Acknowledgements
BAOMS and the Charitable Trustees of LTHT for funding
The H&N MDT at LTHT
