Discussing future expectations with incurable breast cancer patients: Quality of communication from a patient perspective.

Good communication is essential in health care, especially in sensitive areas such as the transition from curative to palliative cancer care. While all patients want to be aware of their disease’s terminal nature, how explicit oncologist should be in their prognostic information is still unknown. In addition, the need for hope persists for all cancer patients, at the same time as the need for honest information. But what comprises hope is still unknown and an empirical base for its beneficial effect is lacking. The aim of this project is to determine optimal communication strategies for prognostic disclosure in the palliative phase of breast cancer from a patient perspective. In a first study, breast cancer survivors’, healthy women’s and oncologists’ opinions on which topics they consider important when discussing a palliative prognostic disclosure and how oncologists can trade the fine lines between providing general as opposed to explicit information and realistic as opposed to hopeful information when discussing these topics are explored. With the data of this first study, 4 written scripts and role-played video-vignettes of a prognostic disclosure are created in which the level of explicitness of information and expressed hope are systematically varied. Breast cancer survivors and healthy women watch these video-vignettes and their perceptions of the communication are assessed. A sub sample of the subjects will participate in focus groups to provide qualitative information about their opinions concerning the varied communication elements.

The aim of this project is to determine optimal communication strategies for prognostic disclosure in the palliative phase of breast cancer from a patient perspective.

Study 1: To explore breast cancer survivors’, healthy women’s and oncologists’ opinions on which topics they consider important when discussing a palliative prognostic disclosure and how oncologists can trade the fine lines between providing general as opposed to explicit information and realistic as opposed to hopeful information when discussing these topics.

Study 2: To determine the main and interaction effects of the levels of explicitness of information and expressed hope when providing prognostic disclosure in palliative breast cancer, using a systematic controlled study design (participants watch created video-vignettes in which the level of explicitness and hope are systematically varied).

Study 1:

Qualitative data during the focus groups.



Study 2:

1. At T(0) (one time, before watching video): Anxiety: STAI-trait and STAI-state.


2. At T(1)-T(4) (4 times, after watching every video):

A. Satisfaction: PSQ and self created 0-10 VAS scale;

B. Anxiety reduction: STAI-state and self-created 0-10 VAS scale;

C. Uncertainty reduction: Self created 0-10 VAS scale;

D. Self efficacy: Self created 0-10 VAS scale;

3. At T(5): During focusgroup qualitative data.

Study 1:

Focus groups (for breast cancer survivors and healthy subjects) and semi-structured interviews (for oncologists).



Study 2:

Self created, standardized videos in which the level of explicitness of information and expressed hope are systematically varied will be shown to healthy subjects and breast cancer survivors to assess the elements’ impact on their perceptions. A subsample of the subjects will participate in focus groups to provide qualitative information about their opinions concerning the varied communication elements.