Attention to the Values, Wishes and Needs of Patients With Advanced Cancer by Hospital Clinicians, an Exploratory Qualitative Study.
Sita de Vries, Laury Pijnappel, Sigrid Vervoort and 3 others
PMID 39229838WHAT IT FOUND
Clinicians said they asked open questions to understand patient values, but observation showed they mostly asked closed questions.
Care depended on the individual clinician's personal views, with no systematic way to track what mattered to patients.
Key findings
01There was a gap between what clinicians said they did and what they actually did: most claimed to ask open questions, but observations showed they mostly asked closed questions.
02Attention to patient values depended on the individual clinician's personal opinions about safety, decision-making, and alignment, rather than a systematic hospital approach.
03Patient-Reported Outcome Measures (PROMs) were not used or even acknowledged by the clinicians during the observed consultations.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single-site study in a Dutch academic hospital, limiting generalizability. Small, homogeneous sample of clinicians (mostly female, experienced). Observations included patients at various stages of illness (curative to palliative), which may affect communication dynamics. Findings are based on clinician perspective only; patient experiences were not directly reported in this study.
Declared interests
The authors declared no potential conflicts of interest. The work was supported by the Jonker-Driessen Foundation.
The easy way to misread this
Do not conclude that clinicians are intentionally withholding information or failing in their duties. The study suggests that clinicians' personal values and a desire to 'protect' patients lead to implicit, inconsistent communication about values and wishes. It is not evidence of negligence, but of a systemic lack of tools (like PROMs) and training to handle these conversations consistently.