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Physician empathy for patients with lung cancer lacking
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According to recently published data, empathic responses from thoracic surgeons and oncologists to questions or concerns from patients with lung cancer are rare and often late.
A qualitative thematic analysis of 20 audio-recorded consultations between patients with lung cancer and their thoracic surgeons or oncologists was conducted by researchers from the University of Rochester in New York, Hebrew University of Jerusalem in Israel and the University of Illinois at Chicago. The researchers obtained the recordings from an observational study that included 137 patients from a Veterans’ Affairs hospital.
The researchers developed seven subthemes:
1. Morbidity and mortality concerns;
2.
Cancer-related symptoms;
3. Relationship to smoking;
4. Decisions about
treatment;
5. Beliefs of mistrust of medical care;
6. Factors limiting
ability to treat cancer; and
7. Confusion regarding cancer status and
treatment.
The audio-recorded transcripts were coded by patients’ statements about the impact of lung cancer, patients’ statements about disease diagnosis or treatment and patients’ statements about health system issues affecting their care. The researchers then analyzed patient opportunities and physician responses.
Physicians responded to 39 (10%) of 384 identified empathic opportunities. Physicians were more likely to respond to concerns coded as health care issues (23%) and difficulties with deciding on treatment (21%). Other non-empathic responses included biomedical questions or statements with little emotional support, according to the researchers.
According to the researchers, half of empathic responses were received by patients in the last third of their encounters with their physicians, though their questions or concerns were raised from onset to conclusion of the encounter.
Arch Intern Med. 2008;168:1853-1858.