How and why clinicians avoid communicating prognosis

Prognosis communication is a significant area of patient dissatisfaction, and one of the most difficult aspects of health care clinicians' roles. The aim of this research was to investigate how prognosis is communicated between medical, nursing and allied health clinicians. A case series method was utilised, sampling patients with haematological malignancies in an acute care setting. Multidisciplinary clincians and patient records provided the data, which were then thematically analysed. Three major findings were revealed: 1. the term prognosis conjures the concept of death; 2. clinicians aren't prepared to discuss prognosis, even with each other, and 3. there is a prescribed pathway for patients, related to clinicians expectations. These findings lead to the conclusion that both the psychosocial and scientific spheres of prognosis can be valued in communication and decision-making by clinicians, and that prognosis communication is better understood as regular discussion, rather than a singular concept. The research informs the field of prognosis communication, patient decision-making, and pre- service health education.