title: Patients' reports of barriers to expressing concerns during cancer consultations.
abstract: OBJECTIVE
  To identify cancer patients' most influential barriers to expressing concerns during cancer consultations in a new manner by examining patients' reports of perceived barriers and perceived occurrence of barriers in consultations.
  
  
  METHODS
  Two online focus groups (N=16) and an online survey (N=236) were conducted among cancer patients and cancer survivors. The online focus groups and survey were used to examine two elements of patients' barriers, i.e., patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Composite scores of these two elements were calculated to determine influential barriers.
  
  
  RESULTS
  Results showed that the most influential barriers were related to providers' behavior (e.g., providers do not explicitly invite patients to express concerns) and the environment where the consultation takes place (e.g., perceived lack of time).
  
  
  CONCLUSIONS
  The results of this study indicate that influential barriers to expressing concerns are barriers that patients cannot overcome themselves (i.e., they are related to providers' behavior or the environment of the consultation). A collaborative approach between researchers, providers and policy makers is needed to overcome these barriers.
  
  
  CONCLUSIONS
  The results of this study can be used to develop strategies to overcome barriers to patients expressing concerns.
authors.affiliation: Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: k.brandes@uva.nl.
authors.forename: Kim
authors.initials: K
authors.lastname: Brandes
authors.affiliation: Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Annemiek J
authors.initials: AJ
authors.lastname: Linn
authors.affiliation: Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Edith G
authors.initials: EG
authors.lastname: Smit
authors.affiliation: Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Julia C M
authors.initials: JC
authors.lastname: van Weert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003142:Communication; D003144:Communication Barriers; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010465:Perception; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors
keywords: Barriers; Cancer patients; Communication; Expressing concerns; Healthcare providers