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August 15, 2019

Communication Strategies for Sharing Prognostic Information With Patients: Beyond Survival Statistics

Author Affiliations
  • 1Ariadne Labs, Brigham and Women’s Hospital, the Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 2Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 3Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
JAMA. 2019;322(14):1345-1346. doi:10.1001/jama.2019.11533

Communicating prognosis, the anticipated course of living with an illness, is a core clinical skill and a foundation of the patient-clinician relationship. Clinicians find such communication challenging. Concerns about professional helplessness when caring for a patient with a disease with a poor prognosis and the desire to avoid difficult patient and personal emotions can lead to an understandable reluctance to share difficult news with patients and families. Clinicians also struggle to find the right words to balance hope with concern when sharing difficult news.1 While receiving prognostic information is difficult for patients, not receiving prognostic information can create anxiety and may distance patients from their clinicians, who are often aware of the prognosis but do not share it with patients. Delaying or avoiding communication about prognosis also risks patients not having the information they need to make decisions and leads to missed opportunities to set and achieve goals that reflect what matters most to them.

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