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Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management

Identifieur interne : 003961 ( Pmc/Curation ); précédent : 003960; suivant : 003962

Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management

Auteurs : Kea Turner [États-Unis] ; Cleo A. Samuel [États-Unis] ; Heidi As Donovan [États-Unis] ; Ellen Beckjord [États-Unis] ; Alexandra Cardy [États-Unis] ; Mary Amanda Dew [États-Unis] ; Gj Van Londen [États-Unis]

Source :

RBID : PMC:5363398

Abstract

Purpose

Providers’ communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care.

Methods

We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street’s (2007) Framework for Patient-Centered Communication in Cancer Care.

Results

The findings of this study suggest providers’ communication behaviors including managing survivors’ uncertainty, responding to survivors’ emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers’ discipline.

Conclusion

There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers’ roles in symptom assessment, and determine best practices for AET symptom communication.


Url:
DOI: 10.1007/s00520-016-3491-9
PubMed: 27864628
PubMed Central: 5363398

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PMC:5363398

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<title>Conclusion</title>
<p id="P4">There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers’ roles in symptom assessment, and determine best practices for AET symptom communication.</p>
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Department of Health Policy and Management, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, USA</aff>
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Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, USA</aff>
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University of Pittsburgh Medical Center Cancer Center, School of Nursing, University of Pittsburgh, 415 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, USA</aff>
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University of Pittsburgh Medical Center Health Plan, University of Pittsburgh, 600 Grant Street, Pittsburgh, PA, USA</aff>
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Departments of Psychiatry, Psychology, Epidemiology, Biostatistics, and Clinical and Translational Science, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA, USA</aff>
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Department of Medicine, University of Pittsburgh, A. 140 Cooper Pavilion, 5115 Centre Avenue, Pittsburgh, PA, USA</aff>
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<abstract>
<sec id="S1">
<title>Purpose</title>
<p id="P1">Providers’ communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care.</p>
</sec>
<sec id="S2">
<title>Methods</title>
<p id="P2">We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (
<italic>n</italic>
= 13). Themes were organized using Epstein and Street’s (2007) Framework for Patient-Centered Communication in Cancer Care.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">The findings of this study suggest providers’ communication behaviors including managing survivors’ uncertainty, responding to survivors’ emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers’ discipline.</p>
</sec>
<sec id="S4">
<title>Conclusion</title>
<p id="P4">There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers’ roles in symptom assessment, and determine best practices for AET symptom communication.</p>
</sec>
</abstract>
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<kwd>Aromatase inhibitors</kwd>
<kwd>Symptom management</kwd>
<kwd>Patient-centered communication</kwd>
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</front>
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