How do Hematologists Communicate with Patients Suffering from Chronic Lymphocytic Leukemia?

Insights from the ERIC Pilot Study in Greece

Abstract

Chronic Lymphocytic Leukemia (CLL) is a chronic hematologic malignancy with great heterogeneity and unpredictable clinical course. The European Research Initiative on CLL (ERIC), in the context of its CLL Patient Empowerment Program, conducted a study exploring hematologists’ experience of communication. Thirty semi-structured interviews were conducted with hematologists caring for CLL patients in Greece. Inductive thematic qualitative analysis was employed revealing 3 major themes: (i) disclosure of information encompassing ‘negotiating the level of disclosure’, ‘the power of cultural perceptions’, ‘fear of being held culpable’, ‘fear of patients’ and own emotions’; (ii) medical-decision making which described ‘balancing autonomy and beneficence’, ‘considering patients’ preferences’ and ‘adhering to practice guidelines’; (iii) emotional support which included ‘assessment of emotional distress’, ‘identifying and regulating patients’ emotions’ and ‘maintaining a supportive relationship’. In conclusion, physicians are aware of the importance of communication and its potential impact on CLL patients. They use a wide range of communication strategies which serve the diversity of communication goals they must achieve. However, the majority have not received formal education on patient interactions. Present findings highlight the need for specific communication protocols, guidance and training that will empower physicians to overcome challenges, inherent to the nature of CLL.