Effective communication between doctors and patients in oncological settings

Interactions between doctors and patients in the oncological setting can be highly challenging. Different ways of communicating the same information can significantly affect patient’s understanding, emotional responses, and behaviors (including the quality of engagement in the relationship, coping strategies, therapeutic adherence, etc.). These outcomes can also depend on socio-demographic variables, dispositional traits, personal preferences about receiving bad news and knowing the truth, as well as on the specific stage of illness. Although doctor-patient interactions in oncological settings have been broadly investigated in many Western countries, and several protocols for effective communication have been proposed, research on the specific characteristics of Italian oncological settings has failed so far to produce theoretically sound, evidence-based recommendations for clinicians. Existing studies are either insufficiently grounded theoretically (e.g. Pensieri et al. 2018) or are based only on specific phases of the consultation (e.g. Fatigante et al. 2016; Zucchermaglio et al. 2016). In order to fill these gaps, this project adopts a multidisciplinary perspective, combining psychological, linguistic, and sociological insights, with the following theoretical and practical objectives. On a theoretical level, we aim at 1. reconsidering the issue of asymmetry in the oncological setting from dialogical, relational, and epistemic stance perspectives. 2. increasing the knowledge on which relational dimensions of doctor-patient communication can influence cancer patients’ attitudes and behaviors, by assessing the impact that different ways of sharing information, handling the emotional dimension, facilitating patients’ engagement during decision-making processes, and managing the setting have on the overall satisfaction of doctors and patients. 3. testing the hypothesis according to which different patients not only have different preferences and expectations about receiving bad news and knowing the truth, but also resort to different coping strategies in dealing with stressful situations, and allow themselves to be differently engaged in the relationship. These objectives will be pursued through 1. the collection, transcription, and analysis of a corpus of audio-recorded doctor-patient interactions; 2. the collection, transcription and analysis of a set of audio-recorded interviews, that will be conducted separately with oncologists and patients; 3. the administration and analysis of a self-report questionnaire, that will be addressed to a purposely recruited sample of oncological patients. On a practical level, we aim to create and publish the first corpus of transcripts of Italian spoken interactions in the oncological setting. This corpus will represent the first step towards the creation of a shared body of textual data collected in different clinical settings, which will be accessible to and queryable by the scientific community.

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