title: Patients' and family members' views on patient-centered communication during cancer care.
abstract: OBJECTIVE
  To explore patients' and family members' views on communication during cancer care and to identify those aspects of clinician-patient communication which were most important to patients and family members.
  
  
  METHODS
  We conducted a secondary data analysis of qualitative data from 137 patients with cancer and family members of patients with cancer. We used a modified version of the constant comparative method and coding paradigm of grounded theory.
  
  
  RESULTS
  Patients want sensitive, caring clinicians who provide information that they need, when they need it, in a way that they can understand; who listen and respond to questions and concerns, and who attempt to understand the patient's experience. Effective information exchange and a positive interpersonal relationship with the clinician were of fundamental importance to patients and family members. These were interrelated; for instance, failure to provide information a patient needed could damage the relationship, whereas excellent listening could foster the relationship. Information exchange and relationship were also integral to decision-making, managing uncertainty, responding to emotions, and self-management. Clinicians who were responsive to patients' needs beyond the immediate medical encounter were valued.
  
  
  CONCLUSIONS
  The complexity of cancer care today suggests that efforts to improve communication must be multilevel, acknowledging and addressing patient, clinician, organizational and policy barriers, and facilitators. Measurement tools are needed to assess cancer patients' and family members' experiences with communication over the course of cancer care to provide meaningful, actionable feedback to those seeking to optimize their effectiveness in communicating with patients with cancer.
authors.affiliation: Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group, Fallon Community Health Plan, Worcester, MA, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Mazor
authors.forename: Reneé L
authors.initials: RL
authors.lastname: Beard
authors.forename: Gwen L
authors.initials: GL
authors.lastname: Alexander
authors.forename: Neeraj K
authors.initials: NK
authors.lastname: Arora
authors.forename: Cassandra
authors.initials: C
authors.lastname: Firneno
authors.forename: Bridget
authors.initials: B
authors.lastname: Gaglio
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Greene
authors.forename: Celeste A
authors.initials: CA
authors.lastname: Lemay
authors.forename: Brandi E
authors.initials: BE
authors.lastname: Robinson
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Roblin
authors.forename: Kathleen
authors.initials: K
authors.lastname: Walsh
authors.forename: Richard L
authors.initials: RL
authors.lastname: Street
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Gallagher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013997:Time Factors; D035501:Uncertainty; D014481:United States; D055815:Young Adult
keywords: cancer; interviews; oncology; patient-centered communication; qualitative