Patient's perceptions of oral and oropharyngeal cancer diagnosis disclosure: communication aspects based on SPIKES protocol

Carolina G B Alves; Ana Carolina Prado Ribeiro; Thaís Bianca Brandão; Juliana O Tonaki; Caique Mariano Pedroso; César Rivera; Joel B Epstein; Cesar Augusto Migliorati; Luiz Paulo Kowalski; Milena Perez Mak; Gilberto Castro; Marcio Ajudarte Lopes; Alan Roger Santos-Silva

doi:10.1016/j.oooo.2022.12.008

Patient's perceptions of oral and oropharyngeal cancer diagnosis disclosure: communication aspects based on SPIKES protocol

Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 Apr;135(4):518-529. doi: 10.1016/j.oooo.2022.12.008. Epub 2022 Dec 23.

Affiliations

¹ Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil.
² Psychology Service, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil.
³ Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
⁴ Oral Medicine and Pathology Research Group, Faculty of Health Sciences, University of Talca (UTALCA), Talca, Maule Region, Chile.
⁵ Cedars-Sinai Health System, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
⁶ College of Dentistry, University of Florida, Gainesville, FL, USA.
⁷ Department of Head and Neck Surgery, University of São Paulo Medical School (FMUSP), São Paulo, Brazil.
⁸ Department of Medical Oncology, Instituto do Câncer do Estado de São Paulo, University of São Paulo Medical School (ICESP-FMUSP), São Paulo, Brazil.
⁹ Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil. Electronic address: Alanroger@fop.unicamp.br.

PMID: 36740563
DOI: 10.1016/j.oooo.2022.12.008

Abstract

Objective: Breaking bad medical news is a complex task of clinical practice. The manner in which this is done has a significant impact on patients. This study aimed to assess patient's perceptions regarding oral and oropharyngeal cancer diagnosis disclosure according to the "SPIKES" protocol.

Study design: This cross-sectional study used a questionnaire with 21 SPIKES-based items. The questionnaire was administered to 100 patients with recently diagnosed oral and oropharyngeal squamous cell carcinoma who evaluated each item according to their preference and experience.

Results: Nineteen items showed a significant difference between patient's preference and recalled experience. Eighteen of these items showed lower experience scores primarily related to the amount of information desired by patients, presence of a companion, time to express feelings, and summary of information. Most patients preferred receiving as much information as possible about the diagnosis. However, only 35% reported that they had obtained sufficient information. Patients who were aware of cancer diagnostic suspicion had better communication experiences.

Conclusions: Protocols may be useful to guide health professionals to support patient-centered strategies to disclose oral cancer diagnoses.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Communication
Cross-Sectional Studies
Humans
Oropharyngeal Neoplasms* / diagnosis
Physician-Patient Relations
Truth Disclosure*