Doctor-patient communication in Chinese cancer care: a qualitative exploration

Patient-centred care (PCC) receives less attention in developing countries like China. The aim of our study was to qualitatively explore how doctors in China communicate with patients and family in the cancer context and the extent to which they can do this within a model of patient-centred care. We conducted 10 in-depth, semi-structured interviews with doctors (across different cancer specialities) working in one of China's largest cancer hospitals. An inductive thematic analysis was conducted, and we followed a standard process of familiarisation, coding and theme generation. We generated four themes and five sub-themes which reflected the intersectional importance of: the family as gatekeepers to information filtered to the patient about their diagnosis, prognosis and treatment options; the central role of culture in communication (including taboos of cancer and death); the complexity of delivering PCC in this context and the conflicting and stressful role of the doctor. There may be scope for developing and testing culturally appropriate and acceptable interventions to challenge the taboos of cancer and death and to educate the nation on basic disease processes. Moreover, communication skills training in having difficult conversations and discussing cancer-specific end-of-life care may support patients in living and dying well with cancer in China. New developments in Artificial Intelligence may help facilitate this.