Exercise shared decision-making after understanding how doctors think
James Fleck: Anticancerweb 25(07), 2020
Anticancer Tutorial is a pedagogical resource created to inform the patient of the steps involved in the diagnosis and treatment of cancer. As a cognitive process, the tutorial promotes empathy, improving doctor-patient relationship. It brings language closer, explains technical procedures and creates mutual understanding. The tutorial encourages a proactive attitude in the patient, promoting the search for information and leading to a better understanding of the physician’s recommendations. When facing cancer, doctors and patients have to share goals and motivations. The tutorial is an attempt to change the patient's attitude, rejecting passive behavior, immobility and tacit acceptance of the disease. By improving communication, the tutorial can lead to better results in most interventions proposed by doctors.
The tutorial was created as a responsive tool. You can consult it on a computer, tablet or smartphone. You can browse through 12 icons, indicating the most important phases of a comprehensive cancer patient assessment. By clicking on each of the icons, you will be guided on the meaning of each phase and better understand the set of decisions that doctors need to make in the diagnosis and treatment of cancer.
If you are having a cancer diagnosis or are a family member of a cancer patient, you might benefit from the tutorial. However, it is advisable to share the decision with your attending physician. Your attending physician can better assess whether the tutorial is right for your specific case. My experience with the patients who took the tutorial under supervision was favorable. Most of the time, it took about one hour. In general, patients took the tutorial in my office's waiting room and in the family environment, which facilitated the sharing of information, both with the doctor and family members.
Here is the link to the tutorial:
http://www.jamesfleck.com/tutorial?locale=en
References:
1. James Fleck: Advice in Clinical Oncology, Link: www.jamesfleck.com
When facing cancer, the good quality of the doctor-patient relationship is indispensable and is associated to better outcomes. With the Anticancer Tutorial, this relationship can become closer and more transparent. Through the knowledge that the Anticancer Tutorial provides, the patient will have all the information they need and will be able to participate more actively in your treatment.
We always hear about "informed consent" but how informed a patient can be if he doesn't have the basic knowledge of how oncology works? This tutorial solves part of this problem and also provides the patient important information which will help him to be more active in his treatment process.
We know how painful and difficult it is for a cancer patient to discover the diagnosis and the treatment process, whether palliative or curative. I believe that the Anticancer Tutorial is an important tool to strengthen the ties between the doctor and the patient, mainly for the optimization of the treatment. A patient welcomed, assisted and mainly understood, certainly feels safer to face the battles of his treatment, which also extends to his family members, who are fundamental parts in this journey. Oncological patients have fears, uncertainties and several internal conflicts in the face of the diagnosis, therefore, this tutorial only tends to add up, enabling greater understanding and active participation of the patient and family in the most appropriate choices for their treatment.
In the fight against cancer the patients many times come with a series of preconceived ideas about its problem. It's a part of the roll of the attending physician being sure that that patient will fully understand its condition. When this is done, the patient is able to really be part of the decision making referring to its treatment and assume an active stance towards its condition. The tutorial helps the physician in this process of educating the patient ant its family.
The impact of cancer in patients’ lives varies according to how they address fears, concerns and emotions. In this context, physicians play a key role by providing support and eliciting the patients’ collaboration in developing a strategy of treatment for the future. This tool enables patients to better understand their own process, therefore increasing confidence in the physicians’ empathic perception and ability to provide the best care. Shared decision making as well as fully understanding of the condition definetly encourage patients to fight cancer.
Indeed, the burden of a cancer diagnosis may be different among patients, but in a general way it's harmful in a emotional and psychological way. Education and understanding of this "inner enemy" might play an important role in mitigating this harmful process. If a tool like this one, easily accessible, is widespread through society, there's a chance that people start to face cancer in a more healthy way.
In shared decision-making progress such as this anticancer tutorial, the patient’s thoughts, fears and ambitions are in the center of the decision-making – and I believe that this is the most important aspect of implementing a tool with this kind of purpose. The SPIKES protocol, regarding its particularities, shares the same core thought about managing difficult situations. The bond between the physician and the patient is essential to build a relationship where the doctor can see beyond the disease and understand the actual illness scenario.
It is very interesting to create a resource that brings information to the patient about his condition and about the main related aspects, which can contribute to him becoming the protagonist of his treatment. In this sense, the anticancer tutorial emerges as a tool in the fight against cancer, focused on helping to prepare the main soldier for the battle, after all, the doctor may be important, but the doctor is an adjunct who acts in favor of his patient, so that ideally, decisions should be shared between doctor and patient in a joint effort for a better result.
Understanding the impact of a medical condition should never be restricted to the physician. After all, the disease is much more relevant for the patient than anyone else. The Anticancer Tutorial is a great tool to provide the patient an active role throughout the treatment. In fact, the Tutorial has the potential to become a key instrument in building a great doctor-patient relationship, even in the settings of other diseases.
In oncology, the doctor-patient relationship is particularly important due to the severity of the disease and the stigma that often accompanies the patient's experience. Unfortunately, many professionals have not been properly trained to deal with these situations. In this way, Anticancer Tutorial is a very important tool, because it can help in the way the patient faces the disease.
This is a remarkably interesting tool that might enhance several aspects of medical aid. I believe that it is capable of empowering the patient, making him/her encounter his/her disease process with more autonomy and knowledge. As part of the patient’s protagonism, there are diverse benefits: improvement of mental health, development of a better medical-patient relationship, enhancement of treatment adherence, and even greater chances of therapeutic success. The switch from a passive approach to a more critical view deconstructs any hierarchical scenario in medical care.
The knowledge about the illness is extremely important to the patient. When the patient understand how things work, how the physician takes the decisions and what are the phases of the treatment, the patient starts to talk with the physician not only in a passive way, taking control of his own life. Giving information to the patient helps to built a solid relationship between patient and physician, which also helps to cope with the disease.
A cancer diagnosis brings difficult emotions and feelings to patients and their families, which is even harder to deal when there is lack of information about the disease. Patient education relieves the anxiety about their new condition and improves their sense of control over their health. Therefore, this tool is a great way to increase their participation in the decision making process and to improve the doctor–patient relationship, which certainly enhances the patient's engagement on the treatment plan. So, it will, for sure, benefit a lot of patients!
Increasing a patient’s knowledge and understanding about his or her disease leads to more informed decision-making, superior quality of life and better treatment adherence and risk factor modification; this is especially important in chronic diseases, and even more so in life-threatening ones, such as cancer. Anticancer Tutorial is a prime example of how technology can be used to achieve these goals, providing a rich and reliable source of information for patients and their family members, and partially compensating for often limited consultation times.
The diagnosis of cancer usually involves a huge emotional burden and a lot of fear from the patient. To alleviate suffering, the understanding of the condition and the possibilities and perspectives for treatment is essential. For that, the tutorial is very useful, mostly if guided by a physician.
One of the contributions that a tool like the tutorial would give us if used widely would be to change the stigma that a disease like cancer has. The view that we have starts from a concept that a patient must "face the enemy within" and must "fight courageously in this battle". But, in fact, instead of magnifying the disease itself, we must provide the patient with knowledge so that coping takes place in the best way, both physically and spiritually. Therefore, a tool that sheds light on technical, scientific, social and psychological issues could be a bedrock to deconstruct this stigma that the patient has to face a battle alone, deconstructing the idea that there is an enemy, which often shakes and weakens the patient's emotional state. Furthermore, there would be a strengthening of the doctor-patient relationship by expanding the use of the tool.
I strongly believe that this type of informative tutorial can bring many benefits to facilitate the communication between the doctor and the patient, making the patient understand more clearly what the doctor is saying and proposing, which ends up bringing real benefits at the moment to make shared decisions. Also, a better informed patient will certainly have a greater ability to express their doubts, fears and anxieties to their doctor, again being beneficial for someone who is going through such a delicate health situation.
The diagnosis and coping with cancer are difficult times for the patient. It is up to the doctor to develop mechanisms that are easy to understand for those who are experiencing a delicate moment, the doctor-patient relationship at that moment will be one of the determinants for the end of the treatment. A tool like the one proposed above helps to make the patient aware of the problem that he is passive and not just a figure in front of the doctor.
Having a tutorial that helps in one of the most important moments - communicating bad news - makes a lot of difference for the doctor. Diagnosing and dealing with cancer is a very difficult time for patients, who usually find it more difficult to deal with a physician in such a situation experience. Therefore, having a tutorial for these moments helps a lot in the way the doctor will deal with the patient's cancer-related issues.
Nowdays, technology is a major part of our lives, it is really simple and valid to use its resources in several areas of expertise, so it is in medical practice. This tutorial presented provides assistance both ways: to the doctor, in simplifying technical knowledge transfer, and to the patient, who is provided with empowerment from self-taught or active knowledge aquisition. All of this, is of a great importance: in your diseace status understanding and in sharing the decision-making with your phisician, to actively fight cancer. Pedagogical initiatives like this should be further explored in healthcare.
Receiving a cancer diagnosis is undoubtly one of the hardest moments one can live. Therefore, in this situation the medical-patient relatioship is even more important and the doctor's hability of sharing knowledge and informing the pacient about his diagnosis is crucial. The Anticancer Tutorial comes as an innovative resourse to keep the patient and his family involved in the treatment and to allow better understanding of the physician’s recommendations. Certainly an informed and involved patient is capable of actively participating in the decision making process, which improves the doctor-patient relashionship and the patient's engagement on the treatment.
The diagnosis of cancer is an emotionally challenging moment for the patient and their loved ones, since cancer is often accompanied by stigma and fear. In this context, the existence of an informative tutorial, such as the Anticancer Tutorial, is extremely relevant, as it can help to demystify the disease, providing clear facts and discouraging misconceptions. This helps patients better understand their illness, enabling them to make informed decisions together with their physicians, which helps patients to be actively involved in their own care and enhances the doctor-patient relationship.
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