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Updated: Feb 13, 2026

Perspectives on Neuroscience
Published on: July 31, 2007
Exploring symptom meaning: perspectives of palliative care physicians
Celina F Estacio1, Phyllis N Butow2, Melanie R Lovell1,3
1Centre for Medical Psychology and Evidence-based Decision-Making, and Kolling Institute, Northern Clinical School, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia.
Context:
Understanding patients' symptom experiences is essential to providing effective clinical care. The discussion between patients and physicians of symptom meaning and its significance, however, is ill understood.
Objectives:
To investigate palliative care physicians' understanding of symptom meaning, and their experiences of and attitudes towards the discussion of symptom meaning with patients.
Methods:
Semi-structured interviews were conducted (N = 17) across Sydney, Australia. Transcripts were analysed using framework analysis.
Results:
Six key themes were identified: (1) definitions of symptom meaning (causal meanings, functional impact, existential impact, and cascade of meanings); (2) meanings are personal (demographic, culture, spiritual, and family differences); (3) eliciting meanings requires subtlety and trust (following the patient's cues); discussing meaning can be (4) hard (for the patient and health professional); (5) therapeutic (assuaging fears, feeling listened to and valued, increased sense of control, and reduced symptom distress); and (6) enhances clinicians' practice and work satisfaction (provision of more tailored care, reassurance through the provision of information, and strengthening of doctor-patient relationship).
Conclusions:
Exploring symptom meaning can serve to provide information, alleviate anxiety, and facilitate individualised care, but only when patients present cues or are open to discuss symptom-related concerns. However, various barriers hinder such dialogue in consultations. Greater awareness of symptom meaning and its influence may facilitate physicians exploring symptom meaning more with patients in the future.
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