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01-12-2017

Communicating Uncertain News in Cancer Consultations

Authors: Francesca Alby, Cristina Zucchermaglio, Marilena Fatigante

Published in: Journal of Cancer Education | Issue 4/2017

Abstract

In cancer communication, most of the literature is in the realm of delivering bad news while much less attention has been given to the communication of uncertain news around the diagnosis and the possible outcomes of the illness. Drawing on video-recorded cancer consultations collected in two Italian hospitals, this article analyzes three communication practices used by oncologists to interactionally manage the uncertainty during the visit: alternating between uncertain bad news and certain good news, anticipating scenarios, and guessing test results. Both diagnostic and personal uncertainties are not hidden to the patient, yet they are reduced through these practices. Such communication practices are present in 32 % of the visits in the data set, indicating that the interactional management of uncertainty is a relevant phenomenon in oncological encounters. Further studies are needed to improve both its understanding and its teaching.

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Hedging devices in professionals’ talk include verbs (e.g., think, suggest, guess), auxiliaries (e.g., might, may, could), nouns (e.g., estimate), adverbs (e.g., roughly, approximately, about), and so forth, which limit the strength of the speaker’s commitment to the certainty of his assertion. Contrast is a rethorical device often deployed in the accounting practices of both patients and doctors to represent the different characters and event involved in the decision-making process.

The rest of the corpus included follow-ups and visits in which a treatment recommendation was delivered during the encounter.

Adopting a sociocultural perspective [20], we refer here to practices as a set of communicative actions through which doctors make diagnoses in a system of specialized medical activity such as oncology..

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Title: Communicating Uncertain News in Cancer Consultations
Authors: Francesca Alby
Cristina Zucchermaglio
Marilena Fatigante
Publication date: 01-12-2017
Publisher: Springer US
Published in: Journal of Cancer Education / Issue 4/2017
Print ISSN: 0885-8195
Electronic ISSN: 1543-0154
DOI: https://doi.org/10.1007/s13187-016-1070-x

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