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Changing communication needs and preferences across the cancer care trajectory: insights from the patient perspective

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Abstract

Purpose

In this program of research, we sought to expand our understanding of how cancer patients' communication needs and preferences change across the course of their illness trajectory. To address known limitations in the empirical knowledge base, we designed a study capitalizing on representative patient reports as they occurred within time and across experience obtaining care for this disease.

Methods

We used a longitudinal cohort design informed by interpretive description methodology to follow 125 patients over a multi-year period as they reflected on their ongoing experiences with cancer care communication.

Results

In relation to each phase of their cancer care trajectory, patients identified tension points and contextual challenges impinging on what they felt constituted helpful and unhelpful patient–provider communication.

Conclusions

Findings from this study create a dynamic portrait of how we can better inform communication approaches and interventions through interpretations of population knowledge and individual experience.

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References

  1. Arora NK (2003) Interacting with cancer patients: the significance of physicians' communication behavior. Soc Sci Med 57:791–806

    Article  PubMed  Google Scholar 

  2. Baile WF, Aaron J (2005) Patient-physician communication in oncology: past, present, and future. Curr Opin Oncol 17(4):331–335, 331–335

    Article  PubMed  Google Scholar 

  3. Epstein RM, Street RL (2007) Patient-centered communication in cancer care: promoting healing and reducing suffering. NIH Publication No. 07–6225. http://outcomes.cancer.gov/areas/pcc/communication/pcc_monograph.pdf

  4. Hagerty RG, Butow PN, Ellis PM, Dimitry S, Tattersall MH (2005) Communicating prognosis in cancer care: a systematic review of the literature. Ann Oncol 16:1005–1053

    Article  CAS  PubMed  Google Scholar 

  5. Epstein RM, Franks P, Fiscella K, Shields CG, Meldrum SC, Kravitz RL, Duberstein PR (2005) Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues. Soc Sci Med 61:1516–1528

    Article  PubMed  Google Scholar 

  6. Rotor DL (2003) Observations on methodological and measurement challenges in the assessment of communication during medical exchanges. Patient Educ Couns 50:17–21

    Article  Google Scholar 

  7. Friedrichsen MJ, Strang PM, Carlsson ME (2002) Cancer patients' interpretations of verbal expressions when given information about ending cancer treatment. Palliat Med 16:323–330

    Article  PubMed  Google Scholar 

  8. Ong LM, Visser MR, van Zuuren FJ, Rietbroek RC, Lammes FB, de Haes JC (1999) Cancer patients' coping styles and doctor-patient communication. Psychooncology 8:155–166

    Article  CAS  PubMed  Google Scholar 

  9. Hack TF, Degner LF, Parker PA, SCRN Communication Team (2005) The communication goals and needs of cancer patients: a review. Psychooncology 14:831–845

    Article  PubMed  Google Scholar 

  10. Kreps GL (2003) The impact of communication on cancer risk, incidence, morbidity, mortality and quality of life. Health Commun 15:161–169

    Article  PubMed  Google Scholar 

  11. Prinz C (2012) Disparities in cancer care: are we making progress? Cancer 118:867–868

    Article  Google Scholar 

  12. Carlson LE, Feldman-Stewart D, Tishelman C, Brundage M, SCRN Communication Team (2005) Patient-professional communication research in cancer: an integrative review of research methods in the context of a conceptual framework. Psychooncology 14:812–828

    Article  PubMed  Google Scholar 

  13. Mazor K, Roblin D, Greene S, Lemay C, Firneno C, Prouty C, Horner K, Gallagher K (2012) Toward patient-centered cancer care: patient perceptions of problematic events, impact, and response. J Clin Oncol 30:1784–1790

    Article  PubMed Central  PubMed  Google Scholar 

  14. Ellis PM, Tattersall MH (1999) How should doctors communicate the diagnosis of cancer to patients? Ann Med 31:336–341

    Article  CAS  PubMed  Google Scholar 

  15. Fogarty LA, Curbow BA, Wingard JR, McDonnell K, Somerfield MR (1999) Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol 17:371–379

    CAS  PubMed  Google Scholar 

  16. Mager WM, Andrykowski MA (2002) Communication in the cancer 'bad news' consultation: patient perceptions and psychological adjustment. Psychooncology 11:35–46

    Article  PubMed  Google Scholar 

  17. Finset A, Smedstad M, Ogar B (1997) Physician-patient interaction and coping with cancer: the doctor as informer or supporter? J Cancer Educ 12:174–178

    CAS  PubMed  Google Scholar 

  18. Sardell AN, Trierweiler SJ (1993) Disclosing the cancer diagnosis: procedures that influence patient hopefulness. Cancer 72:3355–3365

    Article  CAS  PubMed  Google Scholar 

  19. Berry DL, Wilkie DJ, Thomas CRJ, Fortner P (2003) Clinicians communicating with patients experiencing cancer pain. Cancer Investig 21:374–381

    Article  Google Scholar 

  20. Ong LM, Visser MR, Lammes F, de Haes JC (2000) Doctor-patient communication and cancer patients' quality of life and satisfaction. Patient Educ Couns 41:145–156

    Article  CAS  PubMed  Google Scholar 

  21. Fallowfield L, Ratcliffe D, Jenkins V, Saul J (2001) Psychiatric morbidity and its recognition by doctors in patients with cancer. Br J Cancer 84:1011–1015

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Sollner W, DeVries A, Steixner E, Lukas P, Sprinzl G, Rumpold G, Maislinger S (2001) How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 84:179–185

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Gafni A, Charles C, Whelan T (1998) The physician-patient encounter: the physician as a perfect agent for the patient versus the informed treatment decision-making model. Soc Sci Med 47:347–354

    Article  CAS  PubMed  Google Scholar 

  24. Hotson K (2003) Can lack of communication kill? Can Family Physician 49:492–495

    Google Scholar 

  25. Liang W, Burnett CB, Rowland JH, Meropol NJ, Eggert L, Hwang YT, Silliman RA, Weeks JC, Mandelblatt JS (2002) Communication between physicians and older women with localized breast cancer: implications for treatment and patient satisfaction. J Clin Oncol 20:1008–1016

    Article  PubMed  Google Scholar 

  26. Bredart A, Bouleuc C, Dolbeault S (2005) Doctor-patient communication and satisfaction with care in oncology. Curr Opin Oncol 17:351–354

    Article  PubMed  Google Scholar 

  27. Carlson LE, Bultz BD (2003) Benefits of psychosocial oncology care: improved quality of life and medical cost effect. Health Qual Life Outcome 1:8. doi:10.1186/1477-7525-1-8

    Article  Google Scholar 

  28. Salander P (2002) Bad news from the patient's perspective: an analysis of the written narratives of newly diagnosed cancer patients. Soc Sci Med 55:721–732

    Article  PubMed  Google Scholar 

  29. Schofield PE, Butow PN, Thompson JF, Tattersall MHN, Beeney LJ, Dunn SM (2003) Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 14:48–56

    Article  CAS  PubMed  Google Scholar 

  30. Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K (2005) Approaching difficult communication tasks in oncology. CA Cancer J Clin 55:164–177

    Article  PubMed  Google Scholar 

  31. Merckaert I, Libert Y, Razavi D (2005) Communication skills training in cancer care: where are we and where are we going? Curr Opin Oncol 17:319–330

    Article  PubMed  Google Scholar 

  32. Fellowes D, Wilkinson S, Moore P (2004) Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database Syst Rev Issue 2, Art No: CD003751. DOI: 10.1002/14651858.CD003751.pub2

  33. Moore P, Rivera Mercado S, Grez Artiwques M, Lawrie T (2013) Communication skills training for healthcare professionals working with people who have cancer Cochrane Database Syst Rev DOI: 10.1002/14651858.CD003751.pub3

  34. Feldman-Stewart D, Brundage MD, Tishelman C, SCRN Communication Team (2005) A conceptual framework for health-professional–patient communication: an application to the cancer context. Psychooncology 14:1–9

    Article  Google Scholar 

  35. Eggly S, Penner L, Albrecht TL, Cline RJW, Foster T, Naughton M, Peterson A, Ruckdeschel JC (2006) Discussing bad news in the outpatient oncology clinic: rethinking current communication guidelines. J Clin Oncol 24:716–719

    Article  PubMed  Google Scholar 

  36. Salmon P, Young B (2013) The validity of education and guidance for clinical communication in cancer care: evidence-based practice will depend on practice-based evidence. Patient Educ Couns 90:193–199

    Article  PubMed  Google Scholar 

  37. Thorne SE (2008) Interpretive description. Left Coast Press, Walnut Creek, CA

    Google Scholar 

  38. Thorne S, Armstrong E-A, Harris SR, Hislop TG, Kim-Sing C, Oglov V, Oliffe JL, Stajduhar KI (2009) Patient real-time and 12-month retrospective perceptions of difficult communications in the cancer diagnostic period. Qual Health Res 19:1383–1394

    Article  PubMed  Google Scholar 

  39. Thorne S, Oliffe JL, Kim-Sing C, Hislop TG, Stajduhar K, Harris SR, Armstrong E-A, Oglov V (2010) Helpful communications during the diagnostic period: an interpretive description of patient preferences. Eur J Cancer Care 19:746–754

    Article  CAS  Google Scholar 

  40. Thorne S, Oliffe JL, Stajduhar KI (2013) Communicating shared decision making: cancer patient perspectives. Patient Educ Couns 90:291–296

    Article  PubMed  Google Scholar 

  41. Thorne SE, Taylor K, Stephens J, Kim-Sing C, Hislop T (2013) Of guinea pigs and gratitude: the difficult discourse of clinical trials from the cancer patient perspective Eur J Cancer Care 22(5):663–672

    CAS  Google Scholar 

  42. Thorne SE, Stajduhar KI (2012) Patient perceptions of communications on the threshold of cancer survivorship: implications for provider responses. J Cancer Surviv 6:229–237

    Article  PubMed  Google Scholar 

  43. Stajduhar KI, Thorne SE, McGuiness L, Kim-Sing C (2010) Patient perceptions of helpful communication in the context of advanced cancer. J Clin Nurs 19:2039–2047

    Article  PubMed  Google Scholar 

  44. Hoerger M, Epstein RM, Winters P, Fiscella K, Duberstein PR, Gramling R, Butow PN, Mohile S, Kaesberg P, Tang W, Plumb S, Walczak A, Back AL, Tandredi D, Venuti A, Cipri C, Escalera G, Ferro C, Gaudion DBH, Leatherwood B, Lewis L, Robinson M, Sullivan P, Kravitz RL (2013) Values and opinions in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers. BMC Cancer 13:188

    Article  PubMed Central  PubMed  Google Scholar 

  45. Thorne SE, Kuo M, Armstrong E-A, McPherson G, Harris S, Hislop G (2005) "Being known:" patient perspectives on human connection in cancer care. Psychooncology 14:887–898

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by grants from the Canadian Institutes of Health Research (#134487) and the Canadian Cancer Society Research Institute (#020376).

Conflict of interest

The authors confirm that they have no financial relationship with the organization that sponsored the research. They also confirm that they have full control of all primary data and agree to allow the journal to review their data if requested.

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Correspondence to Sally Thorne.

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Thorne, S., Hislop, T.G., Kim-Sing, C. et al. Changing communication needs and preferences across the cancer care trajectory: insights from the patient perspective. Support Care Cancer 22, 1009–1015 (2014). https://doi.org/10.1007/s00520-013-2056-4

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  • DOI: https://doi.org/10.1007/s00520-013-2056-4

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