Professionals' diagnostic and prognostic communication practices in cancer, and the mediating effect of illness perceptions on quality of life in brain tumour patients

Smithson Evans, Francesca

Clinical psychology
June 2016

Thesis or dissertation


Rights
© 2016 Francesca Smithson Evans. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.
Abstract

The portfolio has three parts. Part one is a systematic literature review, in which the empirical literature relating to general disclosure practices of clinicians regarding the diagnosis and prognosis of cancer is reviewed. Part two is an empirical paper, which explores the potential mediating effect of illness perceptions on the relationship between diagnosis communication and quality-of-life in people with a brain tumour. Part three comprises the appendices.

Background: Oncology patients have expressed the wish to be informed of diagnostic and prognostic information in an open and timely manner. The positive outcomes of having these discussions has been researched, both in relation to patients and their caregivers. Investigations of clinicians’ personal opinions about disclosure have revealed the majority believe patients should be told their diagnosis. However, historically it has not always been the case that clinicians disclose this information in practice.

Procedure: A systematic literature search was conducted, and the relevant data was extracted and presented using a narrative synthesis approach.

Participants: 3479 qualified clinicians with a range of specialities working with oncology patients were included in this review.

Findings: This review suggests clinicians do not consistently disclose diagnosis and prognosis to cancer patients, which stands in conflict with patient preferences and service guidelines. There is an apparent difference between clinicians’ opinion and their clinical practice, with more clinicians believing the diagnosis and prognosis should be disclosed in comparison to their reported practice. A vast array of factors contributed to clinicians’ disclosure practices, but due to a high level of inconsistency, general disclosure practices cannot be attributed to any consistent clinician, personal, or patient factors alone.

Conclusions: Not all clinicians report they routinely disclose diagnostic and prognostic information to patients, and there are a number of factors they consider when making this decision. More should be done within services to increase disclosure rates to bring this in line with patient preferences and current guidelines.

Publisher
Department of Psychological Health and Wellbeing, The University of Hull
Qualification level
Doctoral
Qualification name
ClinPsyD
Language
English
Extent
2 MB
Identifier
hull:14523
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