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134 Cancer progression and treatment change: what role does partnership play in shared decision- making?
  1. Julia Kolly1,
  2. Sophie Lelorain1,
  3. Kristopher Lamore2
  1. 1Université de Lausanne, Institut de Psychologie, laboratoire de Psychologie de la santé, du sport et du vieillissement, PHASE, Suisse
  2. 2Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Affectives, F-59000 Lille, France

Abstract

Context The extension of life expectancy and medical advancements lead to a complexification of cancer care pathways marked by phases of resistance to treatments. Announcements of cancer progression generate psychological distress among patients, their caregivers, and healthcare professionals. In the context of two qualitative studies conducted with these three actors, the experiences of these consultations, as well as the shared decisions regarding changes in treatment approaches or not, have been investigated.

Method Semi-structured research interviews were conducted with 20 healthcare professionals (oncologists, surgeons, and nurses), and interviews are being conducted with 10 patients and 10 caregivers. Recruitment will be completed by February 2024. The collected data underwent thematic content analysis for healthcare professionals, and an interpretative phenomenological analysis will be performed for patients’ and caregivers’ interviews.

Results The interdisciplinary healthcare team decides on new treatments. During consultations, professionals work with patients and, if present, caregivers, to adjust or discontinue treatment plans. Professionals rely on patient and caregiver knowledge to tailor treatments, considering preferences. The established relationship with the patient-caregiver dyad is crucial for proposing adapted plans and delivering news of progression empathetically.

Discussion The announcement of cancer progression causes psychological distress for healthcare professionals, patients, and caregivers. The decision, made by a team of healthcare professionals, regarding the upcoming treatment (or discontinuation of treatments) must be discussed in partnership with patients and caregivers, considering their choices, and living circumstances. A strong relationship between healthcare professionals, patients, and caregivers, along with empathy, are essential parameters for shared decision-making. Training on how to facilitate shared decision- making is recommended.

Conclusions This study enables a better understanding of communication between healthcare professionals themselves and the patient-caregiver dyad during consultations announcing cancer progression, considering the relationship among these three actors and shared decision-making.

  • Qualitative methods
  • Psycho-oncology
  • Cancer progression
  • Medical communication.

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