Giving and receiving a diagnosis of a progressive neurological condition: A scoping review of doctors' and patients' perspectives

Patient Educ Couns. 2020 Sep;103(9):1709-1723. doi: 10.1016/j.pec.2020.03.023. Epub 2020 Apr 2.

Abstract

Objective: Delivering a life changing diagnosis can be a distressing experience for patients and a challenging task for professionals. Diagnosis delivery can be especially difficult for individuals with neurodegenerative diseases such as motor neurone disease (MND), multiple sclerosis (MS) and Parkinson's disease (PD). This review aims to scope the literature on doctors' and patients' perspectives on diagnosis delivery for these conditions in order to enhance our understanding in this area and identify potential research gaps.

Methods: A scoping review methodology was used, and data were summarised using content analysis.

Results: 47 studies fulfilled the inclusion criteria. Studies showed that although patients were generally satisfied with diagnosis delivery, a considerable proportion was still dissatisfied with aspects of the consultation, especially the information and time provided and the doctor's approach. Only six studies addressed doctors' perspectives, which focused more on doctors' practice.

Conclusion: There was a significant research gap in professionals' perspectives. The review also found that although basic standards of good practice were being met, a significant proportion of patients were dissatisfied with diagnosis communication.

Practice implications: Professionals delivering such diagnoses need to assess and respond to patients' information needs, provide time for questions and maintain an empathic attitude.

Keywords: Breaking bad news; Diagnosis communication; Motor neurone disease; Multiple sclerosis; Neurodegenerative conditions; Parkinson’s disease; Scoping review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Attitude of Health Personnel
  • Communication
  • Emotions
  • Empathy
  • Health Communication / methods*
  • Humans
  • Motor Neuron Disease / diagnosis
  • Motor Neuron Disease / psychology
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / psychology
  • Neurodegenerative Diseases / diagnosis*
  • Neurodegenerative Diseases / psychology
  • Parkinson Disease / diagnosis
  • Parkinson Disease / psychology
  • Physician-Patient Relations*
  • Physicians / psychology*
  • Referral and Consultation / statistics & numerical data*
  • Truth Disclosure*