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Responding to the active and passive patient: flexibility is the key
Rhonda F Brown1, Phyllis N Butow, Michael Henman
1Medical Psychology Research Unit, University of Sydney, Sydney, NSW 2006, Australia.
Summary
Oncologists can improve shared decision-making by adapting communication strategies to patient participation styles. Helpful techniques include active listening and offering decisional delay for better cancer care.
Area of Science:
- Oncology
- Medical Communication
- Patient-Centered Care
Background:
- Patient preferences for medical decision-making vary significantly.
- Understanding oncologist responses to diverse patient communication styles is crucial.
Purpose of the Study:
- To document oncologist responses to patients exhibiting extreme participation styles.
- To identify effective and ineffective communication strategies for clinicians.
Main Methods:
- Simulated patient consultations using a trained actor portraying two distinct patient styles (anxious-active and depressed-passive).
- 16 medical oncologists participated in videotaped consultations.
- Qualitative analysis of consultations by two trained raters.
Main Results:
- Effective strategies included agenda-setting, active listening, checking understanding, encouraging questions, offering delays, and empathetic non-verbal communication.
- Oncologists adapted to active patients by sharing control and to passive patients by responding to emotional cues.
- Ineffective communication strategies were also identified.
Conclusions:
- Clinicians often lack training in managing diverse patient communication styles, which can impede optimal treatment decisions.
- Oncologists can enhance their communication repertoire with specific strategies for varied patient interactions.