SciELO - Scientific Electronic Library Online

vol.18 issue4Anatomic study of the atlas for surgical planning of lateral mass screw fixation: is it safe in our population?Subcapital femoral neck fracture in patients with HIV and osteonecrosis of the femoral head author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand



Related links

  • On index processCited by Google
  • On index processSimilars in Google


SA Orthopaedic Journal

On-line version ISSN 2309-8309
Print version ISSN 1681-150X


BROWN, O et al. Communicating about prognosis with regard to osteosarcoma in a South African cross-cultural clinical setting: strategies and challenges. SA orthop. j. [online]. 2019, vol.18, n.4, pp.46-51. ISSN 2309-8309.

BACKGROUND: Effective prognostic communication with patients is a prerequisite for treatment decision-making, yet it is a difficult task to manage with confidence. This paper explores the strategies used and challenges faced when communicating about prognosis in a cross-cultural clinical setting. Patients and methods: We used a qualitative exploratory descriptive contextual design and gathered data using focus group interviews with healthcare professionals. Twenty-three healthcare professionals participated in three focus groups. We analysed the data thematically. Guba's Model of Trustworthiness was used to ensure rigour. RESULTS: Our findings revealed strategies for communicating about prognosis. Assessing patient emotions and knowledge, and providing patients with clear prognostic information, emerged as prominent strategies. Healthcare professionals proposed communicating frankly about the consequences of not treating osteosarcoma, treatment limitations, metastases and poor prognoses. They also suggested presenting prognostic information in a staged approach, normalising death, and not specifying life expectancy. In addition, informing patients that a palliative amputation would help with pain management emerged as a strategy for instilling hope. Various patient, provider and disease factors were identified as challenges when discussing prognosis CONCLUSIONS: Deviations from Western research findings emphasised the need for studies exploring prognostic communication in cross-cultural encounters. Our study highlighted the need for creative and thoughtful approaches to communicating sensitive information in cross-cultural clinical settings Level of evidence: Level 5

Keywords : prognosis; patient-provider communication; cancer; osteosarcoma; cross-cultural.

        · text in English     · English ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License