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Dumping the information bucket: A qualitative study of clinicians caring for patients with early stage non-small cell lung cancer.

Golden SE, Thomas CR, Moghanaki D, Slatore CG, Early Stage Lung Cancer Comparative Effectiveness Research Consortium. Dumping the information bucket: A qualitative study of clinicians caring for patients with early stage non-small cell lung cancer. Patient education and counseling. 2017 May 1; 100(5):861-870.

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OBJECTIVE: To evaluate the quality of patient-clinician communication and shared decision making (SDM) when two disparate treatments for early stage non-small cell lung cancer (NSCLC) are discussed. METHODS: We conducted a qualitative study to evaluate the experiences of 20 clinicians caring for patients with clinical Stage I NSCLC prior to treatment, focusing on communication practices. We used directed content analysis and a patient-centered communication theoretical model to guide understanding of communication strategies. RESULTS: All clinicians expressed the importance of providing information, especially for mitigating patient worry, despite recognition that patients recall only a small amount of the information given. When patients expressed distress, clinicians exhibited empathy but preferred to provide more information in order to address patient concerns. Most clinicians reported practicing SDM, however, they also reported not clearly eliciting patient preferences and values, a key part of SDM. CONCLUSION: Communication with patients about treatment options for early stage NSCLC primary includes information giving. We found that only a few communication domains associated with SDM occurred regularly, and SDM may not be necessary in this clinical context. PRACTICE IMPLICATIONS: Clinicians may need to incorporate nurse navigators or more written materials for effectively discussing potentially equivalent treatment options with their patients.

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