Patient perceptions of helpful communication in the context of advanced cancer
Kelli I Stajduhar
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorSally E Thorne
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorLiza McGuinness
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorCharmaine Kim-Sing
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorKelli I Stajduhar
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorSally E Thorne
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorLiza McGuinness
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorCharmaine Kim-Sing
Authors: Kelli I Stajduhar , PhD, RN, Associate Professor, University of Victoria School of Nursing, Vancouver, British Columbia; Sally E Thorne , PhD, RN, Professor & Director, University of British Columbia School of Nursing, Vancouver, British Columbia; Liza McGuinness , MA, Research Manager, British Columbia Centre for Disease Control, Vancouver, British Columbia; Charmaine Kim-Sing , MB, ChB, FRCPC, Clinical Associate Professor, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Search for more papers by this authorAbstract
Aims and objectives. Based on a secondary analysis of data from a large qualitative study on cancer care communication, we address the question: what do patients with advanced cancer identify as helpful in their communication encounters with health care providers?
Background. Communication is of critical importance to the care of patients with advanced cancer. A better understanding of what such patients identify as helpful in their communication encounters with nurses and other health care providers seems critical to creating evidence-informed recommendations for best practices.
Design. Secondary analysis of qualitative interview data.
Methods. Data from 18 participants interviewed individually and 16 focus group participants, with advanced cancer in the palliative phase of care. Interpretive description methodology informed data collection and analysis.
Results. Findings suggest four key elements are critically important to consider in communications with patients in an advanced or palliative phase – respecting the importance of time, demonstrating caring, acknowledging fear and balancing hope and honesty in the provision of information.
Conclusions. Communication is an important element in the provision of advanced cancer care.
Relevance to clinical practice. Findings emphasise the complex meanings inherent in cancer care communication and identify central themes that are fundamental to effective cancer care communication.
References
- Bottorff JL (1993) The use and meaning of touch in caring for patients with cancer. Oncology Nursing Forum 20, 1531–1538.
- Bottorff JL, Gogag M & Engelberg-Lotzkar M (1995) Comforting: exploring the work of cancer nurses. Journal of Advanced Nursing 22, 1077–1084.
- Byock I (2000) Completing the continuum of cancer care: integrating life-prolongation and palliation. CA: A Cancer Journal for Clinicians 50, 123–132.
- Degner LF, Gow CM & Thompson LA (1991) Critical nursing behaviours in care for the dying. Cancer Nursing 14, 246–253.
- Doane GH & Varcoe C (2007) Relational practice and nursing obligations. Advances in Nursing Science 30, 192–205.
- Fallowfield L (1999) Effective communication skills are the key to good cancer care. European Journal of Cancer 35, 1592–1597.
- Ferrell BR & Coyle N (2006) Textbook of Palliative Nursing, 2nd edn. Oxford University Press, Toronto.
- Fleming C, Scanlon C & D’Agostino NS (1987) A study of the comfort needs of patients with advanced cancer. Cancer Nursing 10, 237–243.
- Friedrichsen MJ, Strang PM & Carlsson ME (2000a) Breaking bad news in the transition from curative to palliative cancer care – patient’s view of the doctor giving the information. Supportive Cancer Care 8, 472–478.
- Friedrichsen MJ, Strang PM & Carlsson ME (2000b) Cancer patients’ perceptions of their participation and own resources after receiving information about discontinuation of active tumour treatment. Acta Oncologia 39, 919–925.
- Friedrichsen MJ, Strang PM & Carlsson ME (2002) Cancer patients’ interpretations of verbal expressions when given information about ending cancer treatment. Palliative Medicine 16, 323–330.
- Gattellari M, Voigt KJ, Butow PN & Tattersall MHN (2002) When the treatment goal is not cure: are cancer patients equipped to make informed decisions? Journal of Clinical Oncology 20, 503–513.
- Girgis A & Sanson-Fisher RW (1995) Breaking bad news: consensus guidelines for medical practitioners. Journal of Clinical Oncology 13, 2449–2456.
- Von Gunten CF, Ferris FD & Emanuel LL (2000) The patient-physician relationship: ensuring competency in end-of-life care: communication and relational skills. Journal of the American Medical Association 284, 3051–3057.
-
Heaton J (2004) Reworking Qualitative Data. Sage, London.
10.4135/9781849209878 Google Scholar
- Jarrett NJ & Payne SA (2000) Creating and maintaining ‘optimism’ in cancer care communication. International Journal of Nursing Studies 37, 81–90.
- Kruijver IPM, Kerkstra A, Bensing JM & Van De Wiel HBM (2000) Nurse-patient communication in cancer care: a review of the literature. Cancer Nursing 23, 20–31.
- Kutner JS, Steiner JF, Corbett KK, Jahnigen DW & Barton PL (1999) Information needs in terminal illness. Social Science and Medicine 48, 1341–1352.
- La Monica EL, Madea AR & Oberst MT (1987) Empathy and nursing care outcomes. Scholarly Inquiry for Nursing Practice 1, 197–213.
- Mackillop WJ, Stewart WE & Ginsberg AD (1988) Cancer patients’ perceptions of their disease and its treatment. British Journal of Cancer Care 58, 355–358.
- Mahon S & Casperson D (1997) Exploring the psychosocial meaning of recurrent cancer: a descriptive study. Cancer Nursing 20, 178–186.
- Morales E (1994) Meaning of touch to hospitalized Puerto Ricans with cancer. Cancer Nursing 17, 464–469.
- Morita T, Akechi T, Ikenaga M, Kizawa Y, Kohara H, Mukaiyama T, Nakaho T, Nakashima N, Shima Y, Matsubara T, Fujimori M & Uchitomi Y (2004) Communication about the ending of anticancer treatment and transition to palliative care. Annals of Oncology 15, 1551–1557.
- Parker PA, Baile WF, De Moor C, Lenzi R, Kudelka KP & Cohen L (2001) Breaking bad news about cancer: patients’ preferences for communication. Journal of Clinical Oncology 19, 2049–2056.
- Ptacek JT & Ptacek JJ (2001) Patients’ perceptions of receiving bad news about cancer. Journal of Clinical Oncology 19, 4160–4164.
- Raudonis BM (1993) The meaning and impact of empathic relationships in hospice nursing. Cancer Nursing 16, 304–309.
- Reid-Ponte P (1992) Distress in cancer patients and primary nurses’ empathy skills. Cancer Nursing 15, 283–292.
- Rittman M, Paige P, Rivera J, Sutphin L & Godown I (1997) Phenomenological study of nurses caring for dying patients. Cancer Nursing 20, 115–119.
- Ronaldson S & Devery K (2001) The experience of transition to palliative care services: perspectives of patients and nurses. International Journal of Palliative Nursing 7, 171–177.
- Sapir R, Catane R, Kaufman B, Isacson R, Segal A, Wein S & Cherny NI (2000) Cancer patient expectations of and communication with oncologists and oncology nurses: the experience of an integrated oncology and palliative care service. Supportive Care in Cancer 8, 458–463.
-
Sardell AN &
Trierweiler SJ (1993) Disclosing the cancer diagnosis: procedures that influence patient hopefulness.
Cancer
72, 3355–3365.
10.1002/1097-0142(19931201)72:11<3355::AID-CNCR2820721135>3.0.CO;2-D CAS PubMed Web of Science® Google Scholar
- Stajduhar KI & Davies B (2005) Variations in and factors influencing family members’ decisions for palliative home care. Palliative Medicine 19, 21–32.
- Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, Grambow S, Parker J & Tulsky JA (2001) Preparing for the end of life: preferences of patients, families, physicians and other care providers. Journal of Pain and Symptom Management 22, 727–737.
-
Thorne S,
Reimer Kirkham S &
MacDonald-Emes J (1997) Interpretive description: a non-categorical qualitative alternative for developing nursing knowledge.
Research in Nursing & Health
20, 169–177.
10.1002/(SICI)1098-240X(199704)20:2<169::AID-NUR9>3.0.CO;2-I CAS PubMed Web of Science® Google Scholar
-
Thorne S,
Reimer Kirkham S &
O’Flynn-Magee K (2004) The analytic challenge in interpretive description.
International Journal of Qualitative Methods
3, Retrieved March 9/08 from http://www.ualberta.ca/~iiqm/backissues/3_1/html/thorneetal.html.
10.1177/160940690400300101 Google Scholar
- Thorne SE, Kuo M, Armstrong E, McPherson G, Harris SR & Hislop G (2005a) Being known: patient perspectives on human connection in cancer care. Psycho-Oncology 14, 887–898.
- Thorne SE, Bultz BD & Baile WF (2005b) Is there a cost to poor communication in cancer care?: a critical review of the literature. Psycho-Oncology 14, 875–884.
- Thorne S, Hislop GT, Kuo M & Armstrong EA (2006) Hope and probability: patient perspectives of the meaning of numerical information in cancer communication. Qualitative Health Research 16, 318–336.
- Thorne S, Oglov V, Armstrong EA & Hislop TG (2007) Prognostication futures and the human experience of hope. Palliative and Supportive Care 5, 227–239.
- Thorne SE, Hislop TG, Armstrong EA & Oglov V (2008) Cancer care communication: the power to harm and the power to heal? Patient Education & Counselling 71, 34–40.
- Thorne SE, Hislop TG, Stajduhar K & Oglov V (in press) Time-related communication skills from the cancer patient perspective. Psycho-Oncology. DOI: 10.1002/pon.1418.
- Wilkinson S (1991) Factors which influence how nurses communicate with cancer patients. Journal of Advanced Nursing 16, 677–688.
Citing Literature
