THE DOCTOR, THE PATIENT AND THE UNCERTAINTY. DEVELOPMENT OF A STANDARDIZED RELATIONAL CARE METHOD TO IMPROVE RISK COMMUNICATION TO PATIENTS WITH INDETERMINATE THYROID NODULES

In the era of "personalized care", patient participation in the decision-making and treatment process suggests an approach strongly centered on relationship. Our objective was to develop our own communication method designed to improve the doctor- patient relationship in cases of diagnosed thyroid nodules with indeterminate cytology (TIR3). Fifty-two patients diagnosed with TIR3 were enrolled from March 2023. For the clinical interview, we used the SPIKES-protocol to communicate the risk of neoplastic disease, questionnaires assessing the clarity of medical communication (i-Share Questionnaire), the PHE-scale and SF-36, as well as our risk communication model tool designed "ad hoc" for this study. Interview times were three: first surgical visit, admission, 7 days after surgery. The research approach used was qualitative. According to the SPIKES analysis, all patients showed a complete adherence to protocol, understanding the nature and risks of type of pathology and immediately expressing a support for surgery. The therapeutic choice made was judged correct by almost all of patients. From the analysis of the i-share questionnaire, it was evident that patients had the impression of asking few questions to health care providers about their illness, in particular when side effects were occurred. It's essential to stimulate the patient to ask questions, particularly in relation to the real understanding of disadvantages linked to the surgical procedure. One of the biggest concerns is that communicating uncertainty may have negative effects on patient. However, more than more information, patients need an interpretation of the available data, allowing them to understand which best suits their needs.