The duality of option-listing in cancer care.
Conversation analysis
Decision-making
Doctor-patient communication
Oncology
Journal
Patient education and counseling
ISSN: 1873-5134
Titre abrégé: Patient Educ Couns
Pays: Ireland
ID NLM: 8406280
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
18
12
2018
revised:
29
06
2019
accepted:
23
07
2019
pubmed:
7
8
2019
medline:
28
4
2021
entrez:
7
8
2019
Statut:
ppublish
Résumé
Listing more than one option for treatment, termed "option-listing" (OL) is one way to facilitate shared decision-making. We seek to evaluate how oncologists do option-listing in clinical encounters across disease contexts. We coded and transcribed 90 video-recorded interactions between 5 oncologist participants and a convenience sample of 82 patients at 2 large clinics in the western U.S. We used conversation analytic (CA) methods to examine patterns of behavior when oncologists provided more than one treatment option to patients. In early-stage disease, OL provides patients with options while at the same time constraining those options through expression of physician bias. This effect disappears when cancer is at an advanced stage. In this context, OL is presented without physician preference and demonstrates recission of medical authority. In early-stage contexts, OL functions as a way for physicians to array available options to patients while also communicating their expertise. In advanced-stage contexts, OL functions as a way to minimize treatment options and highlight dwindling possibilities. OL is one way to implement shared decision-making, but it can also be used to facilitate a realization that treatment choices are diminishing and disease is progressing beyond a cure.
Identifiants
pubmed: 31383562
pii: S0738-3991(19)30310-6
doi: 10.1016/j.pec.2019.07.025
pmc: PMC7034307
mid: NIHMS1536558
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Pagination
71-76Subventions
Organisme : NCATS NIH HHS
ID : TL1 TR002388
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.
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