Faith, hope, and charity: an in-depth interview study of cancer patients' information needs and information-seeking behavior

OBJECTIVE: To explore why cancer patients do not want or seek information about their condition beyond that volunteered by their physicians at times during their illness. DESIGN: Qualitative study based on in-depth interviews. SETTING: Outpatient oncology clinics at a London cancer center. PARTICIPANTS: 17 patients with cancer diagnosed in previous 6 months. Main outcome measures Analysis of patients' narratives to identify key themes and categories. RESULTS: While all patients wanted basic information on diagnosis and treatment, not all wanted further information at all stages of their illness. Three overarching attitudes to their management of cancer limited patients' desire for and subsequent efforts to obtain further information : faith, hope, and charity. Faith in their doctor's medical expertise precluded the need for patients to seek further information themselves. Hope was essential for patients to carry on with life as normal and could be maintained through silence and avoiding information, especially too detailed or "unsafe" information. Charity to fellow patients, especially those seen as more needy than themselves, was expressed in the recognition that scarce resources-including information and explanations-had to be shared and meant that limited information was accepted as inevitable. CONCLUSIONS: Cancer patients' attitudes to cancer and their strategies for coping with their illness can constrain their wish for information and their efforts to obtain it. In developing recommendations, the government's cancer information strategy should attend to variations in patients' desires for information and the reasons for them.

[1]  Sue Ziebland,et al.  Analysing qualitative data , 2000, BMJ : British Medical Journal.

[2]  P. Symonds,et al.  Information needs of cancer patients in west Scotland: cross sectional survey of patients' views , 1996, BMJ.

[3]  T. Parsons The Social System , 1953 .

[4]  J. Gabe,et al.  Health and the sociology of emotions , 1996 .

[5]  Gina Wong-Wylie,et al.  Patient Hope: Exploring the Interactions between Physicians and HIV Seropositive Individuals , 1997 .

[6]  L. Fallowfield,et al.  Doctor-patient interactions in oncology. , 1996, Social science & medicine.

[7]  P Maguire,et al.  Confiding in crisis: gender differences in pattern of confiding among cancer patients. , 1995, Social science & medicine.

[8]  Ruth Pinder,et al.  The Management of Chronic Illness , 1990 .

[9]  Lesley Fallowfield,et al.  No news is not good news: Information preferences of patients with cancer , 1995, Psycho-oncology.

[10]  M Baum,et al.  Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. , 1990, BMJ.

[11]  A Coulter,et al.  Evidence based patient information , 1998, BMJ.

[12]  Byrne,et al.  Doctors Talking to Patients , 1984 .

[13]  D. Silverman Interpreting Qualitative Data , 1993 .

[14]  L. Spencer,et al.  Qualitative data analysis for applied policy research , 2002 .

[15]  K. McPherson,et al.  Celebrity's death from cancer resulted in increased calls to CancerBACUP , 1998, BMJ.

[16]  B. Cassileth,et al.  Information and participation preferences among cancer patients. , 1980, Annals of internal medicine.

[17]  K. McPherson,et al.  An analysis of first-time enquirers to the CancerBACUP information service: variations with cancer site, demographic status and geographical location , 1999, British Journal of Cancer.

[18]  P. Butow,et al.  Computer-based interaction analysis of the cancer consultation. , 1995, British Journal of Cancer.

[19]  D. Lupton Your life in their hands : trust in the medical encounter , 1996 .

[20]  P. Houts,et al.  Information needs of families of cancer patients: a literature review and recommendations. , 1991, Journal of cancer education : the official journal of the American Association for Cancer Education.

[21]  T. Lister,et al.  Emotional support for cancer patients: what do patients really want? , 1996, British Journal of Cancer.

[22]  M. Whitehouse,et al.  A policy framework for commissioning cancer services , 1995, BMJ.