The role of congruency in patient-doctor interactions: Insights from rare cancer consultations.

Abstract

This study¹ aims to examine the preferences of patients with rare cancers in their interactions with medical specialists and to analyse the extent to which these preferences are reflected in patients' actual experiences. It further explores how prior experiences contribute to the development of these preferences. In-depth, semi-structured interviews (n = 24) were conducted with patients diagnosed with a rare cancer syndrome and with healthcare professionals (n = 8). The interviews were analysed and coded using the constructing grounded theory (CGT). Six interaction patterns were identified, varying along a spectrum from patient-centred to doctor-centred approaches. Among these, two emerged as most prevalent within the study group: collaborative congruent and active incongruent. Patients describing collaboratively interaction experiences possess strong health literacy skills and actively participate in consultations, particularly in the exchange and co-construction of information. In contrast, those experiencing active incongruency report dissatisfaction with the level of engagement permitted by the medical team as their informational and decision-making needs remain insufficiently addressed. Patients with rare cancers actively engage in knowledge-building efforts, which can shape their expectations regarding interaction opportunities during medical consultations. It is essential for clinicians to recognise and assess patients' and caregivers' expectations regarding information provision and involvement in care and treatment decisions. Tailoring communication strategies to align with patients' interaction preferences can strengthen trust, enhance understanding, support decision-making and facilitate more effective coping with the disease.