Older Cancer Patients Want Empathy from Providers

Last Updated: 2009-02-04 15:55:04 -0400 (Reuters Health)

By Anne Harding

NEW YORK (Reuters Health) - Too often, health care providers don"t take the needs of older cancer patients into account when giving them information on their illness and its treatment, Dutch researchers report.

These patients would benefit from having this information tailored to their needs, and delivered in a way that is helpful to them, rather than being offered a kind of one-size-fits-all approach, Dr. Julia C.M. van Weert of the Netherlands Institute for Health Research in Utrecht and her colleagues say.

"Personal, relevant information is processed more deeply and will therefore be remembered better; this is even more important for older patients as cognitive abilities decrease with age," van Weert told Reuters Health via e-mail.

Van Weert and her team set out to examine the specific information needs of older cancer patients by conducting focus groups with 38 older cancer patients and their relatives, as well as health-care providers involved with nursing, oncology, geriatrics or patient-provider communication.

Two themes emerged on the difference between younger and older patients, the researchers found. The patient and professional groups agreed that processing and remembering information becomes more difficult with age, and because older people have more life experience and often are coping with other illnesses, they may have an easier time accepting their illness. They also might tend to have a different view of their future than a younger patient would.

The patients also frequently talked about the importance of a provider expressing empathy and support and acknowledging their worries and fears. "Showing empathy and support is an important aspect of patient education as this created a trustful environment which gives room for reflection on the information provided and the decision to undergo treatment," van Weert said.

"This is needed because older cancer patients have different life expectations and, consequently, they may have a different view on the added value of undergoing treatment."

Many patients said that they seemed to get "a standard story" driven more by a provider"s "pre-set ideas" than their own needs. "Our results suggest that nurses try to adapt to patients" emotional needs by providing information instead of showing empathy and emotional support, while these latter skills were considered particularly important by the participants in this study," van Weert and her team note in their report.

"Overall, the majority of cancer patients want to receive relevant information about their treatment, but they are, on average, less interested in extensive and detailed information," van Weert explained in the e-mail interview. And rather than trying to provide a patient with all the information that they need all at once, she added, it makes more sense for doctors and nurses to have discussions with older patients at several points during the course of their care.

To help cope with the problems they identified, the researchers have developed a communication training for providers that emphasizes providing tailored information, prioritizing and structuring information, including the patient"s companion in the discussion, and addressing patients" emotions, van Weert noted.

"Although we all know how important it is to provide individual tailored information as well as emotional support, individual patient needs are still often insufficiently explored," she said.

SOURCE: BMC Nursing, January 19, 2009.


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