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What symptoms tell us: A multiple case study of oncology consultations

Published online by Cambridge University Press:  11 September 2020

Céline Bourquin Open the ORCID record for Céline Bourquin [Opens in a new window]  and
Friedrich Stiefel
Céline Bourquin*
Affiliation:
Psychiatric Liaison Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
Friedrich Stiefel
Affiliation:
Psychiatric Liaison Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
*
Author for correspondence: Céline Bourquin, Service de Psychiatrie de liaison, Ave de Beaumont 23, Centre hospitalier universitaire vaudois, 1011Lausanne, Switzerland. E-mail: celine.bourquin@chuv.ch
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Abstract

Objectives

While patients’ symptom experiences have been widely investigated, there is a lack of contextualized studies investigating how symptoms circulate in the medical consultation, how patients present them, what they convey, how physicians respond, and how patients and physicians negotiate with each other to find ways to address them. The aim of this study is to explore patients and physicians handling of symptoms throughout oncological consultations with a multiple case study approach.

Methods

Five consultations, purposively selected from an existing dataset of audiotaped consultations with patients with advanced cancer, were analyzed by means of an inductive analytical approach based on a sensitive framework from the literature.

Results

Patients’ symptoms showed multiple dimensions such as medical, cognitive, emotional, psychological, interactional, symbolic, experiential, and existential.

Significance of results

Different symptom dimensions remained unnoticed and unaddressed in the consultations. The physician-centered symptom approach that was observed leads to consumed time and missed opportunities for relationship building with the patient. Physicians showed a lack of sensitivity regarding the multiple dimensions of symptoms. Based on the findings, strategies for a more comprehensive symptom approach can be conceived.

Keywords

CancerMultiple case studyPalliative patientQualitative researchSymptoms
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 4 , August 2021 , pp. 421 - 436
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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