Table 5.

The partially informed patient

Pat: It’s got here, the more intensive follow‐up schedules may find any recurrent cancer at an early stage, which may or may [not be to an advantage, what does

Nur: [Right

Pat: That mean?

Nur: Well, what it means is that, umm, it’s possible that you could develop a polyp or something like that which might mean that you had extra investigations

Pat: Oh, right

Nur: But it might not necessarily, umm, be something that needs treatment

Pat: Oh right, well, that doesn’t matter does it?

The relevant passage reads:

‘The more intensive follow‐up schedules may find any recurrent cancer at an earlier stage which may or may not be an advantage. They may also find other changes that are not cancer and which don’t need treatment. This may mean that you have more investigations than necessary and this can cause inconvenience and anxiety.’

The nurse only addresses the second part, leaving unexplained the first sentence about recurrent cancer – the one that the patient is confused about. Compare this with another nurse’s successful specification of the ambiguous phrase ‘may or may not be an advantage’, unprompted by the patient.

Nur: Now, what we know with [this] cancer is that, if it comes back, the likelihood of us being able to cure it is very small… erm, what we’d be looking at is controlling it… for a few people, if it comes back and it came in the [organ] which is‐ if it’s going to come back, it’s a common place for it to come ‐ that for a few people you can do surgery and for a few of those, it will cure it, but they’re only a small proportion.