Concordância entre a informação facultada pelo médico e percecionada pelo doente após consulta de oncologia médica

Abstract

Introduction: Effective patient-physician communication is essential to optimize patient-centred care. The study aim is to analyse the degree of agreement between the information provided by the physician and perceived by the patient during the first Medical Oncology (MO)appointment, and to explore factors potentially associated with ineffective communication.
Methodology: Semi-structured interviews with incurable cancer patients and their oncologists were conducted after the first MO appointment. Agreement analysis was done using descriptive statistics and qualitative data were studied using thematic analysis.
Results: Thirteen pairs of interviews were carried out (12 oncologists and 13 patients). Regarding the diagnosis, there was a high level of agreement when assessing what the patient previously knew (85%) and whether the information was actually transmitted (80%), and reduced when the need to receive new information was explored (38%). Concerning thetreatment, agreement was higher for the type of treatment (80%) compared to the discussion of side effects (61%) and of the expected results (61%). In terms of decision making process, the agreement was 92% for the patient's preference and 80% for participation in this process. As for the prognosis, the agreement was only 54% for the assessment of the need for information and 38% for the discussion of this topic. The investigation of factors that influence patient- physician communication identified 3central themes: “the patient is not alone”, “the patient has a past” and “behavioural reaction to the disease”.
Conclusions: The level of agreement depends on the topic under discussion. Compared to other topics, it is clearly less when prognosis is concerned. The patient identifies multiple factors interfering with communication, regarding the different agents, previous experiences, and social and emotional impact of the disease, thus confirming the complexity and the bilateral nature of this process.

Date of Award	29 Jan 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Ana Paula Gonçalves Antunes Sapeta (Supervisor)