Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study

91 Background: Patient-provider communication is essential to delivering high quality cancer care, including post-treatment when survivors have many complex care needs. In this study, we used data collected for quality improvement from a small, feasibility sample to examine patient perceptions of provider communication and inform the development of a new Oncology Survivorship Clinic model. Methods: As part of a pilot project conducted at Kaiser Permanente Northern California (KPNC), we surveyed 51 breast cancer patients post-treatment. The survey included a communication measure from the 2011 Medical Expenditure Panel Survey (MEPS) Experiences with Cancer survey evaluating provider discussions of: surveillance for recurrence; late or long-term treatment effects; healthy lifestyle behaviors; and emotional or social needs. We also examined reports of the six core functions of patient-centered communication (i.e. managing uncertainty, responding to emotions, making decisions, fostering healing relationships, enabling self-management, and exchanging information) using a measure from the Health Information Trends Survey (HINTS) survey. Part of the purpose was to evaluate acceptability of a new Oncology Survivorship Clinic utilizing non-physician providers. Results: The sample included 51 breast cancer patients surveyed in 2016 within six months of treatment completion. Overall, sizable proportions received detailed communication about surveillance (65%), treatment side effects (46%), emotional needs (41%), and healthy lifestyles (71%) and the majority received patient-centered communication (range: 60-73% based on core function). Particular gaps were noted related to provider communication about treatment side effects (54%), emotional/social needs (59%), managing uncertainty (35%), and responding to emotions (40%). Conclusions: Our very preliminary findings suggest that the majority of women had positive communication experiences, including with non-physician providers. However, clear communications gaps existed underscoring future avenues for research and care delivery interventions to address the comprehensive needs of breast cancer patients.

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Patient-Provider Communication, Decision-Making, and Psychosocial Burdens in Palliative Radiotherapy: A Qualitative Study on Patients’ Perspectives

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2021.01.129 ◽

2021 ◽

Author(s):

Jie Jane Chen ◽

Claudia S. Roldan ◽

Alexandra N. Nichipor ◽

Tracy A. Balboni ◽

Monica S. Krishnan ◽

...

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Palliative Radiotherapy ◽

Provider Communication ◽

Patient Provider Communication

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The Role of Patient–Provider Communication in Engagement and Re-engagement in HIV Treatment in Bamako, Mali: A Qualitative Study

Journal of Health Communication ◽

10.1080/10810730.2017.1417513 ◽

2017 ◽

Vol 23 (2) ◽

pp. 129-143 ◽

Cited By ~ 9

Author(s):

Emily A. Hurley ◽

Steven A. Harvey ◽

Peter J. Winch ◽

Mariam Keita ◽

Debra L. Roter ◽

...

Keyword(s):

Qualitative Study ◽

Hiv Treatment ◽

Provider Communication ◽

Patient Provider Communication

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“There Are Still a Lot of Things that I Need”: A Qualitative Study Exploring Opportunities to Improve the Health Services of First Nations People with Arthritis seen at an On-reserve Outreach Rheumatology Clinic

10.21203/rs.3.rs-33106/v1 ◽

2020 ◽

Author(s):

Adalberto Loyola-Sanchez ◽

Ingris Pelaez-Ballestas ◽

Lynden Crowshoe ◽

Diane Lacaille ◽

Rita Henderson ◽

...

Keyword(s):

Qualitative Study ◽

First Nations ◽

Patient Navigator ◽

Provider Communication ◽

Health Providers ◽

Model Of Care ◽

Community Awareness ◽

Patient Reported ◽

Patient Provider Communication

Abstract Background Arthritis is a highly prevalent disease and leading cause of disability in the Indigenous population. A novel model of care consisting of a rheumatology outreach clinic in an on-reserve primary healthcare center has provided service to an Indigenous community in Southern Alberta since 2010. Despite quality assessments suggesting this model of care improves accessibility and is effective in meeting treatment targets, substantial improvements in patient-reported outcomes have not been realized. Therefore, the objective of this study was to explore the experiences of Indigenous persons with arthritis and healthcare providers involved in this model of care to inform the development of health service improvements that enhance patient outcomes.Methods This was a narrative-based qualitative study involving a purposeful sample of 32 individuals involved in the Indigenous rheumatology model of care. Semi-structured in-depth interviews were conducted to elicit experiences with the existing model of care and to encourage reflections on opportunities to improve it. A two-stage analysis was conducted. The first stage aimed to produce a narrative synthesis of sensitizing concepts through a dialogical method comparing people with arthritis and health providers’ narratives. The second stage involved a collective effort to crystalize these sensitizing concepts in specific recommendations to improve the quality of the current model of care. Triangulation, through participant checking and discussion among researchers, was used to increase the validity of the final recommendations.Results Ten Indigenous people with arthritis lived experience, 14 health providers and 8 administrative staff were interviewed. One main overarching theme was identified, which reflected the need to provide services that improve people’s functioning. Further, the following specific recommendations were identified: 1) enhancing patient-provider communication, 2) improving the continuity of the healthcare service, 3) increasing community awareness about the presence and negative impact of arthritis, and 4) increasing peer connections and support among people living with arthritis.Conclusions Improving the quality of the current Indigenous rheumatology model of care requires implementing strategies that improve functioning, patient-provider communication, continuity of care, community awareness and peer support. A community facilitator in a role of a patient navigator could facilitate the implementation of these strategies.

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“There are still a lot of things that I need”: a qualitative study exploring opportunities to improve the health services of First Nations People with arthritis seen at an on-reserve outreach rheumatology clinic

BMC Health Services Research ◽

10.1186/s12913-020-05909-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Adalberto Loyola-Sanchez ◽

Ingris Pelaez-Ballestas ◽

Lynden Crowshoe ◽

Diane Lacaille ◽

Rita Henderson ◽

...

Keyword(s):

Qualitative Study ◽

Health Services ◽

First Nations ◽

Provider Communication ◽

Health Providers ◽

Model Of Care ◽

Community Awareness ◽

Patient Reported ◽

Patient Provider Communication

Abstract Background Arthritis is a highly prevalent disease and leading cause of disability in the Indigenous population. A novel model of care consisting of a rheumatology outreach clinic in an on-reserve primary healthcare center has provided service to an Indigenous community in Southern Alberta since 2010. Despite quality assessments suggesting this model of care improves accessibility and is effective in meeting treatment targets, substantial improvements in patient-reported outcomes have not been realized. Therefore, the objective of this study was to explore the experiences of Indigenous persons with arthritis and healthcare providers involved in this model of care to inform the development of health service improvements that enhance patient outcomes. Methods This was a narrative-based qualitative study involving a purposeful sample of 32 individuals involved in the Indigenous rheumatology model of care. In-depth interviews were conducted to elicit experiences with the existing model of care and to encourage reflections on opportunities to improve it. A two-stage analysis was conducted. The first stage aimed to produce a narrative synthesis of concepts through a dialogical method comparing people with arthritis and health providers’ narratives. The second stage involved a collective effort to synthesize concepts and propose specific recommendations to improve the quality of the current model of care. Triangulation, through participant checking and discussion among researchers, was used to increase the validity of the final recommendations. Results Ten Indigenous people with arthritis lived experience, 14 health providers and 8 administrative staff were interviewed. One main overarching theme was identified, which reflected the need to provide services that improve people’s physical and mental functioning. Further, the following specific recommendations were identified: 1) enhancing patient-provider communication, 2) improving the continuity of the healthcare service, 3) increasing community awareness about the presence and negative impact of arthritis, and 4) increasing peer connections and support among people living with arthritis. Conclusions Improving the quality of the current Indigenous rheumatology model of care requires implementing strategies that improve functioning, patient-provider communication, continuity of care, community awareness and peer support. A community-based provider who supports people while navigating health services could facilitate the implementation of these strategies.

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