Reasons why a cancer survivor may not bring up quality of life issues:
(1) the patient believes that nothing can be done about the problem
(2) the patient thinks that the doctor is not interested
(3) the patient thinks that the doctor does not have the time to discuss the problem
(4) the patient believes that handling the problem is not the doctor's job
(5) the patient is not comfortable (or embarrassed) talking about a problem like sexuality
(6) the patient is willing to discuss issues BUT would like to talk with another health professional
Disclosure of QOL issues was better if:
(1) the doctor always spent time with the patient
(2) care was considered excellent
(3) the patient's physical health was better
(4) the patient felt comfortable talking about a problem
Ways of finding out about quality of life issues (not given in the reference):
(1) make time to ask specific questions requiring a specific answer
(2) look for physical signs and symptoms that may indicate a problem (weight loss may indicate loss of appetite, etc)
(3) ask questions of family members and friends
(4) have other members of the health care team ask about the quality of life issues, then compare notes
(5) provide resources where the patient can learn more about specific issues
(6) a support group (where the patient can learn that other patients have the same issues)
