Cancer survivors' experiences with breakdowns in patient-centered communication

Richard L. Street, Erica Charlot Spears, Sarah Madrid, Kathleen M. Mazor

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: This study analyzed cancer survivors' communication experiences that fell short of being patient-centered. Patients' descriptions of communication “breakdowns” were analyzed according to domain (eg, information exchange, fostering relationships, and managing emotions), whether it was a breakdown of commission (what was communicated) or omission (what should have been communicated) and whether it involved a clinician or the health care organization. Methods: Cancer survivors (from an online panel of patients) completed the Patients Assessment of Communication Experience measure. Ratings less than “excellent” elicited a prompt asking where communication fell short. Communication breakdowns were categorized as one of commission/omission, if it involved a clinician/health care system, and within which communication domain. Thematic analysis explored how communication breakdowns affected respondents' cancer care experiences. Results: Overall communication was rated as less than excellent by 153 respondents, of which 79 identified a specific communication breakdown. Over half (n = 43, 54%) were problems of omission, mostly attributed to interaction with health care organizations (n = 25). Breakdowns of commission (n = 36, 46%) occurred primarily within clinical encounters (n = 32). Most breakdowns were problems of information exchange (49%) or fostering relationships (27%). Three overarching themes emerged—emotional fallout from unmet information needs, inattention to patient perspective, and uncertainty about navigation and team communication. Conclusions: Patient-centered communication breakdowns create distress that worsens patients' cancer care experiences. Communication skills training for clinicians should address listening, perspective taking, and assessing/satisfying patients' information and emotional needs. Health care organizations should enhance processes to provide timely, useful information to patients.

Original languageEnglish
Pages (from-to)423-429
Number of pages7
JournalPsycho-Oncology
Volume28
Issue number2
DOIs
StatePublished - 1 Feb 2019

Fingerprint

Physician-Patient Relations
Survivors
Communication
Neoplasms
Delivery of Health Care
Foster Home Care
Organizations
Nuclear Family
Uncertainty
Patient Care
Emotions

Keywords

  • cancer
  • communication breakdowns
  • information exchange
  • oncology
  • patient-centered communication
  • physician–patient relationships

Cite this

Street, Richard L. ; Spears, Erica Charlot ; Madrid, Sarah ; Mazor, Kathleen M. / Cancer survivors' experiences with breakdowns in patient-centered communication. In: Psycho-Oncology. 2019 ; Vol. 28, No. 2. pp. 423-429.
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Cancer survivors' experiences with breakdowns in patient-centered communication. / Street, Richard L.; Spears, Erica Charlot; Madrid, Sarah; Mazor, Kathleen M.

In: Psycho-Oncology, Vol. 28, No. 2, 01.02.2019, p. 423-429.

Research output: Contribution to journalArticleResearchpeer-review

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