Physician requests by patients with malignant pleural mesothelioma in Japan

Our plain-English summary of Physician requests by patients with malignant pleural mesothelioma in Japan, by Y. Nagamatsu, I. Oze, K. Aoe, et al (BMC Cancer, 2019).

The study

• Authors: Y. Nagamatsu, I. Oze, K. Aoe, K. Hotta, K. Kato, J. Nakagawa, K. Hara, T. Kishimoto, N. Fujimoto
• Journal: BMC Cancer
• Published: 2019;19(1):383
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Malignant pleural mesothelioma (MPM) is a fatal and rare disease that is caused by the inhalation of asbestos. Treatment and care requests made by MPM patients to their physicians were collected and analyzed.

Methods: This cross-sectional survey was part of a larger study (N = 133) regarding the quality of life of MPM patients. Specific responses to two open-ended questions related to patients' requests regarding treatment and care were quantified, analyzed and divided into categories based on content.

Results: Responses (N = 217) from MPM patients (N = 73) were categorized into 24 subcategories and then abstracted into 6 categories. The majority of requests were related to patient-physician communication. Patients wanted clear and understandable explanations about MPM and wanted their physician to deliver treatment based on the patient's perspective by accepting and empathizing with their anxiety and pain. Patients expected physicians to be dedicated to their care and establish an improved medical support system for MPM patients.

Conclusion: Patients with MPM had a variety of unmet needs from their physicians. Physicians who provide care to MPM patients should receive training in both communication skills and stress management. A multidisciplinary care system that includes respiratory and palliative care for MPM patients should be established.

In plain English

This was a cross-sectional survey of patients in Japan with malignant pleural mesothelioma (MPM), which the article describes as caused by inhaling asbestos. It was part of a larger quality-of-life study that collected 133 questionnaires in 2016 through hospitals and support groups. Of these patients, 73 answered two open-ended questions about what they wanted from their doctors. The authors sorted the 217 requests into 24 subcategories and 6 categories. The largest category, with 80 of the 217 requests, was clear explanations. The most frequent single request, mentioned 41 times (56.2% of the 73 respondents), was for doctors to explain the cause of symptoms, curability, prognosis and the treatment plan. Being told everything, including bad news, was requested 17 times; not being told bad news, 5 times. Empathy for victims of asbestos was mentioned 3 times. The authors concluded that MPM patients had a variety of unmet needs from their physicians. They noted low hospital participation and a sample leaning toward patients in early disease stages with good physician relationships.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional descriptive study using a mailed survey; open-ended answers analyzed by qualitative content analysis
• Who was studied: Patients with malignant pleural mesothelioma in Japan. Questionnaires were distributed in February to March 2016 through 64 participating hospitals and through patient and family support groups. Of 133 questionnaires collected, 73 respondents (54.9%) answered the open-ended questions: 61 men and 12 women, with a mean age of 66.8 years (standard deviation 11.3).
• Exposure: Not an exposure study. Asbestos exposure was not measured; the study examined patients' requests to their physicians about diagnosis, treatment and care.
• Main results:
  • The 73 respondents made 217 requests, which were grouped into 24 subcategories and 6 categories.
  • 80 of the 217 requests concerned explanations from the doctor.
  • The most frequent request, for an explanation of the cause of symptoms, curability, prognosis and the treatment plan, was mentioned 41 times (56.2% of the 73 respondents).
  • A request to be told everything including bad news was mentioned 17 times (23.3% of the sample). A request not to be informed about bad news was mentioned 5 times (6.8%).
  • A country-wide specialized care system for MPM was requested 16 times (21.9% of the sample).
  • Empathy from the physician for victims of asbestos was requested 3 times (4.1% of the sample).
  • Patients who did not receive palliative care made more requests in several categories than those who did. The difference was statistically significant for requests about the cause of symptoms, curability, prognosis and treatment plan (p = 0.030).
• The authors' conclusion: The authors concluded that patients with MPM had a variety of needs unmet by their physicians, even when they were in early stages of the disease and had good relationships with their physicians. They recommended that physicians receive training in communication skills and stress management, and that a multidisciplinary care system be established.
• Limitations the authors state:
  • Low participation rate from hospitals (approximately 20%)
  • Bias toward patients in the early stages of MPM and those with a good relationship with their physicians

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Quality of Life, Multidisciplinary Team, Palliative Care.

Related studies

• Quality of life of survivors of malignant pleural mesothelioma in Japan: a cross sectional study — Y. Nagamatsu, I. Oze, et al. (2018)
• National survey of malignant mesothelioma and asbestos exposure in Japan — K. Gemba, N. Fujimoto, et al. (2012)
• Treatment and survival analyses of malignant mesothelioma in Japan — K. Gemba, N. Fujimoto, et al. (2013)
• Clinical investigation of malignant mesothelioma in Japan — N. Fujimoto, K. Aoe, et al. (2010)
• Fatal pleural mesothelioma in Japan (2003-2008): evaluation of computed tomography findings — K. Kato, K. Gemba, et al. (2016)
• Effect of a two-hour training on physicians' skill in interpreting Pneumoconiotic chest radiographs — N.R. Ngatu, S. Suzuki, et al. (2010)

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