title: Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis.
abstract: OBJECTIVE
  This study aims to gain insight into patient-perceived communication barriers and facilitators at different stages after the diagnosis of malignant lymphoma. We have detected patterns to explain when these factors influence communication predominantly.
  
  
  METHODS
  A qualitative approach was applied, derived from the context mapping framework. A total of 28 patients completed a set of assignments about their experiences with provider-patient communication during medical consultations. Subsequently, these patients and nine companions shared their experiences during a semistructured (group) interview, which was recorded on audiotape. The audiotapes and assignments were analysed with MAXQDA software.
  
  
  RESULTS
  From the patients' viewpoint, communicating effectively appears to depend on their own attributes (e.g. emotions), the health care professionals' attributes (e.g. attitude) and external factors (e.g. time pressure). Three patient communication states were identified: (i) overwhelmed, passive; (ii) pro-active, self-motivated; and (iii) proficient, empowered. Patients seem to behave differently in the three communication states.
  
  
  CONCLUSIONS
  This study lists patient-perceived communication barriers and facilitators and identifies three different communication states, which indicate when certain barriers and facilitators are encountered.
  
  
  CONCLUSIONS
  These findings may support health care professionals to tailor the provision of support and information and remove communication barriers accordingly. Additionally, they provide input for interventions to support patients in effective communication.
authors.affiliation: NIVEL, Utrecht, The Netherlands.
authors.forename: Inge Renske
authors.initials: IR
authors.lastname: van Bruinessen
authors.forename: Evelyn M
authors.initials: EM
authors.lastname: van Weel-Baumgarten
authors.forename: Hans
authors.initials: H
authors.lastname: Gouw
authors.forename: Josée M
authors.initials: JM
authors.lastname: Zijlstra
authors.forename: Akke
authors.initials: A
authors.lastname: Albada
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003142:Communication; D003144:Communication Barriers; D005260:Female; D017144:Focus Groups; D006801:Humans; D008223:Lymphoma / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D010817:Physician-Patient Relations; D036301:Qualitative Research
keywords: cancer care; effective communication; malignant lymphoma; oncology; patient participation; patient-provider communication