Master's thesis in medical school: Maria Tennefoss Sørbø

Maria investigated how doctor-patient communication and psychosocial factors affect quality of life at different stages in the course of the disease progression in patients diagnosed with the malignant brain tumor, glioblastoma. The brief summary of the thesis objectives follows below:

Perspectives of Glioblastoma and Related Quality of Life
With Focus on Psychosocial Aspects and Doctor-Patient Communication throughout the Disease Trajectory

Background: My personal experience as a relative when my dad was diagnosed of the malignant brain tumor, glioblastoma (GBM) inspired me to learn more about this disease and the various aspects of it. Moreover, the reported incidence of glioblastoma is higher in Norway, England and France compared to most European countries, and the disease is currently incurable. The big questions are why and how this disparity arises. How does this type of cancer stand out from the others? What kind of psychosocial challenges do the patients meet related to their quality of life? How is the communication adjusted to each patient’s needs in their situation? Although numerous studies aim for improving survival outcomes, it is as important to bear in mind and optimize the quality of life (QoL) during the patients’ terminal phase through good communication and support. This is also pertinent since the existing treatments are ineffective (largely palliative) and patients often experience adverse side effects as a result of both treatment and malignant progression of the disease. A focused perspective of improving treatment and prognosis, should go hand-in-hand with equal focus on the QoL of the patients. A systematic literature review was undertaken to explore these issues.

In addition to the literature review, the original plan was to shadow the oncologists treating patients enrolled on the BORTEM-17 phase 1B/II clinical trial by supernumery visits to the oncology department at Haukeland University Hospital. This was supposed to assess how QoL, ethical perspectives and doctor-patient communication is undertaken in practice in the clinical setting. Due to the COVID-19 pandemic this could not be undertaken, and the project therefore was reformulated as an exclusive literature study. The project aimed to investigate the following:

• Which factors influence quality of life in patients diagnosed with glioblastoma
• How do psychosocial aspects (e.g. cognition, mood, economy, education, support) and doctor-patient communication impact on the   patients’ QoL evaluation,

1. at diagnosis
2. during treatment
3. at progression or end-of-life stages

• How does the impact of psychosocial factors and communication on QoL change during the patient’s disease course?