Informing and involving cancer patients in their own care.

Doctors have long feared that disclosure of a cancer diagnosis may harm the patient. However, the vast majority of cancer patients in more developed countries prefer to have as much information as possible, regardless of whether it is good or bad. Moreover, these patients are often dissatisfied with the amount and quality of information they receive. Additionally, many patients are unable to participate to the extent that they wish in decisions about their own care, and doctors frequently fail to recognise or appreciate the role that their patients prefer in decision-making. Various information resources have been developed to meet the needs of patients and their families. This paper discusses the information needs and participation preferences of patients with cancer and the consequences of not meeting these expectations. The paper then reviews the types of information resources that have been developed focusing on their reported effectiveness. The review concludes with suggestions for future research.

[1]  Justice M D Kirby Cmg Principles of Healthcare Ethics: Consent and the Doctor/Patient Relationship , 1993 .

[2]  T. Whelan,et al.  Evaluation of a patient file folder to improve the dissemination of written information materials for cancer patients , 1998, Cancer.

[3]  S. Kaplan,et al.  Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease , 1989, Medical care.

[4]  J J Taylor,et al.  General information tapes inhibit recall of the cancer consultation. , 1993, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  J. Logue,et al.  Randomized controlled trial to assess the effectiveness of a videotape about radiotherapy , 2001, British Journal of Cancer.

[6]  A. Derdiarian Informational needs of recently diagnosed cancer patients: Part II. Method and description , 1987, Cancer nursing.

[7]  M. R. Visser,et al.  Effect of providing cancer patients with the audiotaped initial consultation on satisfaction, recall, and quality of life: a randomized, double-blind study. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  A R Jadad,et al.  Rating health information on the Internet: navigating to knowledge or to Babel? , 1998, JAMA.

[9]  P M Bossuyt,et al.  Decision support for patients with early-stage breast cancer: effects of an interactive breast cancer CDROM on treatment decision, satisfaction, and quality of life. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  K. Gamble Communication and information: the experience of radiotherapy patients. , 1998, European journal of cancer care.

[11]  W. Mackillop,et al.  Cancer patients' perceptions of their disease and its treatment. , 1988, British Journal of Cancer.

[12]  B. Coyle,et al.  Patient literacy and the readability of written cancer educational materials. , 1995, Oncology nursing forum.

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

[14]  P. Butow,et al.  Communicating prognosis in early breast cancer: do women understand the language used? , 1999, The Medical journal of Australia.

[15]  D Charnock,et al.  DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. , 1999, Journal of epidemiology and community health.

[16]  Making Healthcare Decisions , 2001 .

[17]  P. Maguire,et al.  Communicate with cancer patients: 1. Handling bad news and difficult questions. , 1988, BMJ.

[18]  R. L. Smith,et al.  Changes in physicians' attitudes toward telling the cancer patient. , 1979, JAMA.

[19]  C. McPherson,et al.  Effective methods of giving information in cancer: a systematic literature review of randomized controlled trials. , 2001, Journal of public health medicine.

[20]  J. Pruyn,et al.  Cancer patients' personality characteristics, physician-patient communication and adoption of the Moerman diet. , 1985, Social science & medicine.

[21]  E. Rutgers,et al.  Interpretive Review : Feasibility and Effects of Decision Aids , 2000, Medical decision making : an international journal of the Society for Medical Decision Making.

[22]  E. Cook,et al.  Relationship between cancer patients' predictions of prognosis and their treatment preferences. , 1998, JAMA.

[23]  R. Street,et al.  Increasing patient involvement in choosing treatment for early breast cancer , 1995, Cancer.

[24]  P. Raich,et al.  Literacy, Comprehension, and Informed Consent in Clinical Research , 2001, Cancer investigation.

[25]  P. Butow,et al.  Misunderstanding in cancer patients: why shoot the messenger? , 1999, Annals of oncology : official journal of the European Society for Medical Oncology.

[26]  E. Bruera,et al.  Patient preferences versus physician perceptions of treatment decisions in cancer care. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  F. Davidoff,et al.  Patient-Centered Medicine: A Professional Evolution , 1996 .

[28]  P. Butow,et al.  Audiotapes and letters to patients: the practice and views of oncologists, surgeons and general practitioners , 1999, British Journal of Cancer.

[29]  A. Gafni,et al.  The supportive care needs of newly diagnosed cancer patients attending a regional cancer center , 1997, Cancer.

[30]  A. Gafni,et al.  A randomised trial of two information packages distributed to new cancer patients before their initial appointment at a regional cancer centre. , 1996, British Journal of Cancer.

[31]  D. Tritchler,et al.  Cancer Patients: Their Desire for Information and Participation in Treatment Decisions , 1989, Journal of the Royal Society of Medicine.

[32]  E. Blanchard,et al.  Information and decision-making preferences of hospitalized adult cancer patients. , 1988, Social science & medicine.

[33]  M Boudioni,et al.  Cancer information: a cost-effective intervention. , 1999, European journal of cancer.

[34]  L. Siminoff,et al.  Doctor-patient communication about breast cancer adjuvant therapy. , 1989, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[35]  P. Butow,et al.  When the treatment goal is not cure: are cancer patients equipped to make informed decisions? , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[36]  P. Butow,et al.  Sharing decisions in cancer care. , 2001, Social science & medicine.

[37]  R. Street,et al.  Information-giving in medical consultations: the influence of patients' communicative styles and personal characteristics. , 1991, Social science & medicine.

[38]  L. C. Rainey Effects of preparatory patient education for radiation oncology patients , 1985, Cancer.

[39]  J P Kassirer,et al.  Adding insult to injury. Usurping patients' prerogatives. , 1983, The New England journal of medicine.

[40]  P. Butow,et al.  Promoting patient participation and shortening cancer consultations: a randomised trial , 2001, British Journal of Cancer.

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

[42]  M. Mills,et al.  The importance of information giving for patients newly diagnosed with cancer: a review of the literature. , 1999, Journal of clinical nursing.

[43]  J. de Haes,et al.  Doctor-patient communication: a review of the literature. , 1995, Social science & medicine.

[44]  Barbara Gandek,et al.  Characteristics of Physicians with Participatory Decision-Making Styles , 1996, Annals of Internal Medicine.

[45]  K A Harris,et al.  The informational needs of patients with cancer and their families. , 1998, Cancer practice.

[46]  J Pearson,et al.  Randomised trial of personalised computer based information for cancer patients , 1999, BMJ.

[47]  P. Butow,et al.  The take-home message: patients prefer consultation audiotapes to summary letters. , 1994, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[48]  Informing, communicating and sharing decisions with people who have cancer , 2001 .

[49]  P. Butow,et al.  The dynamics of change: cancer patients' preferences for information, involvement and support. , 1997, Annals of oncology : official journal of the European Society for Medical Oncology.

[50]  J. Saul,et al.  Information needs of patients with cancer: results from a large study in UK cancer centres , 2001, British Journal of Cancer.

[51]  M. Stewart,et al.  Communication patterns of primary care physicians. , 1997, JAMA.

[52]  R. Street,et al.  Patient Participation in Deciding Breast Cancer Treatment and Subsequent Quality of Life , 1997, Medical decision making : an international journal of the Society for Medical Decision Making.

[53]  K. A. McKibbon,et al.  Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications , 1996, The Lancet.

[54]  R. Boakes,et al.  Information booklets about cancer: factors influencing patient satisfaction and utilization. , 1998, Patient education and counseling.

[55]  V. Entwistle,et al.  Decision aids for patients facing health treatment or screening decisions: systematic review , 1999, BMJ.

[56]  K C Carriere,et al.  Information needs and decisional preferences in women with breast cancer. , 1997, JAMA.

[57]  M. Stockler,et al.  The take-home message: doctors' views on letters and tapes after a cancer consultation. , 1993, Annals of oncology : official journal of the European Society for Medical Oncology.

[58]  P. Butow,et al.  Promoting patient participation in the cancer consultation: evaluation of a prompt sheet and coaching in question-asking , 1999, British Journal of Cancer.

[59]  J. Morris,et al.  Offering patients a choice of surgery for early breast cancer: a reduction in anxiety and depression in patients and their husbands. , 1988, Social science & medicine.

[60]  C. Charles,et al.  Lessons learned from the Decision Board: a unique and evolving decision aid , 2000, Health expectations : an international journal of public participation in health care and health policy.

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

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

[63]  L. Fallowfield,et al.  Offering choice of surgical treatment to women with breast cancer. , 1997, Patient education and counseling.

[64]  P Maguire,et al.  Psychological effects of being offered choice of surgery for breast cancer , 1994, BMJ.

[65]  K. Luker,et al.  Decision‐making role preferences and information needs: a comparison of colorectal and breast cancer , 1999, Health expectations : an international journal of public participation in health care and health policy.

[66]  P. Butow,et al.  Patient participation in the cancer consultation: evaluation of a question prompt sheet. , 1994, Annals of oncology : official journal of the European Society for Medical Oncology.

[67]  A Coulter,et al.  Sharing decisions with patients: is the information good enough? , 1999, BMJ.

[68]  A. Liberati,et al.  What doctors tell patients with breast cancer about diagnosis and treatment: findings from a study in general hospitals. GIVIO (Interdisciplinary Group for Cancer Care Evaluation) Italy. , 1986, British Journal of Cancer.

[69]  B. Rimer,et al.  Informed consent: a crucial step in cancer patient education. , 1984, Health education quarterly.

[70]  R. Thomas,et al.  Forewarned is forearmed--benefits of preparatory information on video cassette for patients receiving chemotherapy or radiotherapy--a randomised controlled trial. , 2000, European journal of cancer.

[71]  V. Entwistle,et al.  Giving tape recordings or written summaries of consultations to people with cancer: a systematic review , 2001, Health expectations : an international journal of public participation in health care and health policy.

[72]  S. Westlake,et al.  The effects of psychoeducational care provided to adults with cancer: meta-analysis of 116 studies. , 1995, Oncology nursing forum.

[73]  S. Kaplan,et al.  Expanding patient involvement in care. Effects on patient outcomes. , 1985, Annals of internal medicine.