Objective: Effective patient-physician communication is essential in life-threatening diseases. This is why a specific process, the so-called "diagnosis disclosure visit", is included in the management protocol for cancer patients. The distress engendered by the news may, however, hinder the information process.
Methods: We analyzed the emotional aspects of the consultation before informed consent to clinical trials in 140 patients with advanced cancer, to assess whether emotions interfered with information quality and to evaluate the potential benefit of a second interview with a nurse. Principal component analysis of responses to a self-completed questionnaire determined the satisfaction scores of interviews. Factors predictive of satisfaction were tested with a logistic regression model.
Results: Although most patients rated themselves as fully informed, 37% required additional information. Two variables were significantly correlated with success of the interview: a low depression score on the HADS scale (included in the questionnaire) and a feeling of inability to ask all questions. A second interview with the nurse increased patient satisfaction with the information from 63% to 95% on average.
Conclusion: Cancer patients need information and do not always feel they have received it after speaking to the oncologist. They cannot always express their concerns, or may fear the answers to questions they therefore avoid asking. Depressed patients appear to find it more difficult to understand the information provided.