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Background: Patients may prefer different levels of involvement in decision-making regarding their medical care which may influence their medical knowledge. Objective: We investigated associations of patients' decisional control preference (DCP) with their medical knowledge, ward round performance measures (e.g., duration, occurrence of sensitive topics), and perceived quality of care measures (e.g., trust in the healthcare team, satisfaction with hospital stay). Design: This is a secondary analysis of a randomized controlled multicenter trial conducted between 2017 and 2019 at 3 Swiss teaching hospitals. Participants: Adult patients that were hospitalized for inpatient care. Main Measures: The primary outcome was patients' subjective average knowledge of their medical care (rated on a visual analog scale from 0 to 100). We classified patients as active, collaborative, and passive according to the Control Preference Scale. Data collection was performed before, during, and after the ward round. Key Results: Among the 761 included patients, those with a passive DCP had a similar subjective average (mean ± SD) knowledge (81.3 ± 19.4 points) compared to patients with a collaborative DCP (78.7 ± 20.3 points) and active DCP (81.3 ± 21.5 points), p = 0.25. Regarding patients' trust in physicians and nurses, we found that patients with an active vs. passive DCP reported significantly less trust in physicians (adjusted difference, − 5.08 [95% CI, − 8.69 to − 1.48 points], p = 0.006) and in nurses (adjusted difference, − 3.41 [95% CI, − 6.51 to − 0.31 points], p = 0.031). Also, patients with an active vs. passive DCP were significantly less satisfied with their hospital stay (adjusted difference, − 7.17 [95% CI, − 11.01 to − 3.34 points], p < 0.001). Conclusion: Patients with active DCP have lower trust in the healthcare team and lower overall satisfaction despite similar perceived medical knowledge. The knowledge of a patient's DCP may help to individualize patient-centered care. A personalized approach may improve the patient-physician relationship and increase patients' satisfaction with medical care. Trial Registration: ClinicalTrials.gov (NCT03210987). [ABSTRACT FROM AUTHOR]

Background: Communicating bad news such as a new cancer diagnosis to patients may have a major impact on their well-being. We investigated differences in patients' psychological distress due to the disclosure of bad news by telephone compared to in person in a systematic review and meta-analysis. Methods: We included all studies that investigated anxiety, depressive or post-traumatic stress disorder (PTSD) symptoms in adult patients in whom bad news by telephone compared to in person were disclosed. We systematically searched PubMed, Embase, PsycINFO and CINAHL from the inception of each database to October 18, 2022. We included randomized and non-randomized trials. Results: We screened 5944 studies and included 11 studies in the qualitative analysis and 9 in the meta-analyses, including four randomized controlled trials. Overall, the quality of studies was moderate to good. There was no difference regarding psychological distress when bad news was disclosed by telephone compared to in person with similar symptom levels of anxiety (3 studies, 285 participants; standardized mean difference [SMD] 0.10 [95% CI -0.15 to 0.35]), depression (3 studies, 284 participants; SMD 0.10 [95% CI -0.30 to 0.49]), and PTSD (2 studies, 171 participants; SMD -0.01 [95% CI -0.48 to 0.36]). Results were similar for satisfaction with care. Discussion: This meta-analysis found no difference regarding psychological distress regardless if bad news were disclosed by telephone or in person, but there were overall only few and heterogeneous studies with a small number of eligible patients. The findings suggest that the modality of disclosure might play a secondary role and the way in which the bad news are communicated might be more important. [ABSTRACT FROM AUTHOR]

Communication of "bad news" (such as a new cancer diagnosis) to patients may have a major impact on their well-being. We aimed to investigate differences in psychological distress of breaking bad news in person compared to by telephone in a systematic review and meta-analysis. We included all studies that investigated breaking bad news (such as a new cancer diagnosis or genetic risk for life-limiting diseases) in person compared to by telephone in adult patients regardless of diagnosis regarding the association with symptoms of anxiety, depression or post-traumatic stress disorder. We systematically searched PubMed, Embase, PsycINFO and CINAHL from the inception of each database to June 1, 2021. We included randomized and non-randomized trials. We screened 3625 studies and included eleven studies in the qualitative analysis and nine in the meta-analyses, including four randomized controlled trials. Overall, quality of studies was moderate to good. There was no mean difference regarding psychological distress when bad news was disclosed by telephone compared to in person with similar symptom levels of anxiety (3 studies, 285 participants; standardized mean difference [SMD] 0.10 [95% CI -0.15 to 0.35]), depression (3 studies, 248 participants; SMD 0.10 [95% CI -0.30 to 0.49]), and symptom levels of PTSD (2 studies, 171 participants; SMD -0.01 [95% CI -0.48 to 0.36]). Results: were similar for satisfaction with care. We did not find a difference in psychological distress if breaking bad news was done in person or by telephone but there were too few studies to draw more definite conclusions. Future research is needed to understand in which situation a telephone consultation is appropriate to disclose bad news with a patient. [ABSTRACT FROM AUTHOR]