THE DYNAMICS OF CHANGE - CANCER-PATIENTS PREFERENCES FOR INFORMATION,INVOLVEMENT AND SUPPORT

Background. While the importance of providing individualised communica tion to cancer patients is now well recognised, little is known about the stability and validity of patients' expressed preferences for info rmation and involvement in decision-making. This study explored the st ability and possible predictors of such preferences over time. Patient s and methods. Cancer patients seeing two Medical Oncologists in an ou t-patient clinic at an Australian teaching hospital completed a questi onnaire battery before and directly after one consultation, and before their next consultation. Eighty consecutive patients with heterogeneo us cancers participated in the study. Preferences for general and spec ific information, involvement and support were elicited at each assess ment. Locus of control and patient familiarity with the clinic were me asured before the first consultation. Patient satisfaction with the co nsultation was assessed directly after the consultation. Demographic a nd disease data were recorded for each patient. Results. General prefe rences for information and involvement were relatively stable, at leas t in the short term; however there was considerable variability in pre ferences for specific topics of information. Patients whose condition had recently worsened were more likely to want progressively less invo lvement in decision-making. Gender, the doctor seen and religion were also predictive of patient preferences. Conclusions: Situational facto rs, such as change in disease status, may alter a patient's preference s for information and involvement. If we wish to match the provision o f information and support to the expressed needs of patients, we must ask patients at each consultation what those needs are.