“The median isn't the message”: How to communicate the uncertainties of survival prognoses to cancer patients in a realistic and hopeful way

This study investigated how doctors communicate the uncertainties of survival prognoses to patients recently diagnosed with life‐threatening cancer, and suggests ways to improve this communication. Two hundred thirty‐eight Norwegian oncologists and general practitioners (GPs) participated in Study 1. The study included both a scenario and a survey. The scenario asked participants to respond to a hypothetical patient who wanted to know how long (s)he could be expected to live. There were marked differences in responses within both groups, but few differences between the GPs and oncologists. There was a strong reluctance among doctors to provide patients with a prognosis. Even when they were presented with a statistically well‐founded right‐skewed survival curve, only a small minority provided hope by communicating the variation in survival time. In Study 2, 177 healthy students rated their preferences for different ways of receiving information regarding the uncertainty of a survival prognosis. Participants who received an explicitly described right‐skewed survival curve believed that they would feel more hopeful. These participants also obtained a more realistic understanding of the variation in survival than those who did not receive this information. Based on the findings of the two studies and on extant psychological research, the author suggests much‐needed guidelines for communicating survival prognoses in a realistic and optimistic way to patients recently diagnosed with life‐threatening cancer. In particular, the guidelines emphasise that the doctor explains the often strongly right‐skewed variation in survival time, and thereby providing the patient with realistic hope.     

Addiction Mindsets and Psychological Processes of Quitting Smoking

Background: Lay belief systems about the malleability of human attributes have been shown to impact behavior change in multiple domains. Addiction mindset—i.e., beliefs about the permanence (vs. malleability) of addiction — may affect cigarette smokers’ ability to quit, but this has never been examined. Objectives: The aims of the present research were to develop a measure of addiction mindset (study 1) and examine its associations with various psychological aspects of quitting smoking (study 2). Methods: In Study 1, using factor analysis of current smokers’ and nonsmokers’ (n?=?600) responses to 22 items designed to measure addiction mindset, we developed a reliable six-item Addiction Mindset Scale (AMS). In Study 2, adult smokers (n?=?200) completed the AMS, and measures of a number of psychological processes related to smoking. Results: Higher scores on the AMS, indicative of the belief that addiction is malleable (referred to as a growth mindset), were positively and significantly associated with greater motivation to quit, greater commitment to quitting, greater self-efficacy to abstain, less attribution of failure to lack of ability to change addiction, and fewer self-reported barriers to cessation (all p’s < .05). Conclusions: The results of this study show a relationship between the beliefs about the permanence of addiction and psychological processes relevant to quitting smoking. The findings underscore the potential of future research exploring how addiction mindsets relate to successful smoking cessation as well as other types of addictive behavior and how they can be applied to change people’s behavior.     

The psychological experience of children with cerebral palsy

Many children with cerebral palsy face considerable challenges in their day to day life. Some will be highly dependent on those around them. While motor deficits are most commonly reported, children with cerebral palsy also experience higher rates of challenging behaviour, attention difficulties, social communication problems and to a lesser extent mood disorders in comparison to the general population. Personal risk factors for psychological distress include normal intellect, communication problems and less functional disability. Due to their need for higher levels of care and support, their parent's emotional state and parenting style also highly impacts on the child's development. Research groups have designed parenting interventions and mindfulness groups to support and enhance the parenting of young people with CP. This short article summarises what is known about the psychological experience of children and what interventions are helpful and evidence-based.