Assessing patient-centered communication in cancer care: stakeholder perspectives.
OBJECTIVE
Patient-centered communication is critical to quality cancer care. Effective communication can help patients and family members cope with cancer, make informed decisions, and effectively manage their care; suboptimal communication can contribute to care breakdowns and undermine clinician-patient relationships. The study purpose was to explore stakeholders' views on the feasibility and acceptability of collecting self-reported patient and family perceptions of communication experiences while receiving cancer care. The results were intended to inform the design, development, and implementation of a structured and generalizable patient-level reporting system.


METHODS
This was a formative, qualitative study that used semistructured interviews with cancer patients, family members, clinicians, and leaders of health care organizations. The constant comparative method was used to identify major themes in the interview transcripts.


RESULTS
A total of 106 stakeholders were interviewed. Thematic saturation was achieved. All stakeholders recognized the importance of communication and endorsed efforts to improve communication during cancer care. Patients, clinicians, and leaders expressed concerns about the potential consequences of reports of suboptimal communication experiences, such as damage to the clinician-patient relationship, and the need for effective improvement strategies. Patients and family members would report good communication experiences in order to encourage such practices. Practical and logistic issues were identified.


CONCLUSIONS
Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices. This qualitative study provides a foundation for the design and pilot testing of such a patient reporting system.
Meyers Primary Care Institute, Worcester; Harvard Medical School; Harvard Vanguard Medical Associates, Boston, MA; Mid-Atlantic Permanente Research Institute/Kaiser Permanente Mid-Atlantic States, Rockville, MD; Henry Ford Health System, Detroit, MI; Geisinger Health System; Henry Hood Center for Health Research, Danville; School of Medicine, University of Pennsylvania, Philadelphia, PA; The Center for Health Research, Kaiser Permanente Northwest, Portland, OR; Kaiser Permanente Colorado, Colorado Springs, CO; and National Cancer Institute, Bethesda, MD.
Kathleen M
KM
Mazor
Bridget
B
Gaglio
Larissa
L
Nekhlyudov
Gwen L
GL
Alexander
Azadeh
A
Stark
Mark C
MC
Hornbrook
Kathleen
K
Walsh
Jennifer
J
Boggs
Celeste A
CA
Lemay
Cassandra
C
Firneno
Colleen
C
Biggins
Mary Ann
MA
Blosky
Neeraj K
NK
Arora
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003695:Delivery of Health Care; D005190:Family; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research; D011785:Quality Assurance, Health Care; D057566:Self Report; D011795:Surveys and Questionnaires