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Expectations of treatment outcomes in patients with spinal metastases; what do we tell our patients? A qualitative study Versteeg, Anne L.; Gal, Roxanne; Charest-Morin, Raphaële; Verlaan, Jorrit-Jan; Wessels, Hester; Fisher, Charles G.; Verkooijen, Helena M.

Abstract

Background Realistic pre-treatment expectations are important and have been associated with post-treatment health related quality of life (HRQOL). Patient expectations are greatly influenced by physicians, as they are the primary resource for information. This study aimed to explore the communication practices of physicians regarding treatment outcomes for patients with spinal metastases, and physician experiences with patients’ pre-treatment expectations. Methods An international qualitative study using semi-structured interviews with physicians routinely involved in treating metastatic spine disease (spine surgeons, radiation and medical oncologists, and rehabilitation specialists) was conducted. Physicians were interviewed about the content and extent of information they provide to patients with spinal metastases regarding treatment options, risks and treatment outcomes. Interviews were transcribed verbatim and analyzed using a thematic coding network. Results After 22 interviews data saturation occurred. The majority of the physicians indicated that they currently do not establish patients’ pre-treatment expectations, despite acknowledging the importance of these expectations. Spine surgeons often believe that patient expectations are disproportionate. Physicians expressed they manage expectations by detailing the most common risks and providing a broad but nonspecific overview of treatment outcomes. While the palliative intent seems clear to the physicians, their perception is that the implications of a palliative treatment remains elusive to most patients. Conclusion This study highlights the current gap in patient-physician communication regarding expectations of treatment outcomes of patients with spinal metastases. These results warrant further research to improve communication practices and determine the effect of patient expectations on patient reported outcomes in this population.

Item Metadata

Title
Expectations of treatment outcomes in patients with spinal metastases; what do we tell our patients? A qualitative study
Creator
Versteeg, Anne L.; Gal, Roxanne; Charest-Morin, Raphaële; Verlaan, Jorrit-Jan; Wessels, Hester; Fisher, Charles G.; Verkooijen, Helena M.
Contributor
University of British Columbia. Department of Orthopaedics. Combined Neurosurgical & Orthopaedic Spine Program
Publisher
BioMed Central
Date Issued
2021-11-23
Description
Background Realistic pre-treatment expectations are important and have been associated with post-treatment health related quality of life (HRQOL). Patient expectations are greatly influenced by physicians, as they are the primary resource for information. This study aimed to explore the communication practices of physicians regarding treatment outcomes for patients with spinal metastases, and physician experiences with patients’ pre-treatment expectations. Methods An international qualitative study using semi-structured interviews with physicians routinely involved in treating metastatic spine disease (spine surgeons, radiation and medical oncologists, and rehabilitation specialists) was conducted. Physicians were interviewed about the content and extent of information they provide to patients with spinal metastases regarding treatment options, risks and treatment outcomes. Interviews were transcribed verbatim and analyzed using a thematic coding network. Results After 22 interviews data saturation occurred. The majority of the physicians indicated that they currently do not establish patients’ pre-treatment expectations, despite acknowledging the importance of these expectations. Spine surgeons often believe that patient expectations are disproportionate. Physicians expressed they manage expectations by detailing the most common risks and providing a broad but nonspecific overview of treatment outcomes. While the palliative intent seems clear to the physicians, their perception is that the implications of a palliative treatment remains elusive to most patients. Conclusion This study highlights the current gap in patient-physician communication regarding expectations of treatment outcomes of patients with spinal metastases. These results warrant further research to improve communication practices and determine the effect of patient expectations on patient reported outcomes in this population.
Subject
Spinal metastases; Patient expectations; Health related quality of life; Patient physician communication; Qualitative research
Genre
Article
Type
Text
Language
eng
Date Available
2021-11-23
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0403814
URI
http://hdl.handle.net/2429/80251
Affiliation
Medicine, Faculty of; Non UBC; Medicine, Department of; Orthopaedic Surgery, Department of
Citation
BMC Cancer. 2021 Nov 23;21(1):1263
Publisher DOI
10.1186/s12885-021-08993-0
Peer Review Status
Reviewed
Scholarly Level
Faculty; Other
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)