Physicians' responses to advanced cancer patients' existential concerns: A video-based analysis

Area of Science:

• Oncology
• Medical Communication
• Psychosocial Oncology

Background:

• Patients with advanced cancer experience significant existential distress.
• Effective communication is crucial for addressing patient concerns in oncology.
• Previous research identified patient existential disclosures during consultations.

Purpose of the Study:

• To investigate physician responses to patients' existential concerns during advanced cancer consultations.
• To analyze communication patterns in physician-patient dialogue regarding existential topics.

Main Methods:

• Qualitative, exploratory study design.
• Analysis of video-recorded hospital consultations.
• Microanalysis of face-to-face dialogue.

Main Results:

• 185 physician responses to 127 patient existential utterances were identified.
• Physician responses included giving control, providing support, or taking control.
• Physicians predominantly took control, focusing on biomedical aspects and rarely pursuing existential concerns.

Conclusions:

• Physicians frequently failed to acknowledge or address patients' existential concerns.
• Physicians' tendency to control the conversation limits exploration of existential issues.
• There's a need for improved communication strategies in advanced cancer care.