Physician communication in a lung cancer center--does the message come across?

OBJECTIVE: Lung cancer patients require information about their diagnosis, treatment procedure and the treatment goal. We have examined recall of patients and how satisfied they were with physician communication. PATIENTS AND METHODS: 101 patients with newly diagnosed lung cancer were interviewed shortly after the disclosure of diagnosis about their diagnosis, treatment procedure and treatment goal. Disclosing physicians were asked what information they had given. Physician information and patient recall was then compared. RESULTS: Eighty-six percent (86 of 100 patients) knew their diagnosis, 81% recalled the treatment procedure correctly, and 42% knew if the treatment goal was curative or palliative. We found high satisfaction about communication of diagnosis and treatment procedure (83% resp.77%). However, satisfaction with communication of the treatment goal was 53% (51 of 97 patients) and significantly lower than satisfaction with communication of diagnosis and of treatment procedure. Patients who were informed by male physicians were significantly more satisfied with the disclosure about the treatment goal. CONCLUSIONS: Treatment goals are difficult to convey by untrained physicians. Further research is needed to understand how we can improve patients' understanding of and satisfaction with information about the treatment goal and prognosis and how physicians can improve their communication skills.

[The need for palliative care treatment in pneumology in non-malignant diseases--a case report]. / Bedarf für eine palliativmedizinische Versorgung in der Pneumologie bei nicht malignen Erkrankungen--ein Fallbericht.

A 70-year-old pneumological patient with a COLD for many years, who was using long-term oxygen therapy, developed a complex clinical presentation. During his inpatient course over several weeks we treated severe physical symptoms such as shortness of breath, anxiety and pain. After the transfer to the palliative care ward only an inpatient final accompaniment was possible. In this case the palliative care expertise was integrated too late into the process of the therapy. The delay led to a poorer control of severe physical symptoms such as those named above. Also, the patients request for comprehensive ambulant care could not be realised because the severity of the disease was not detected soon enough. Instruments for the evaluation of the need for an additional palliative care treatment in patients with a non-malignant pneumological disease have not been established sufficiently.