A Patient Centered Approach To Cancer Communication Research Papers

Breast Cancer Prevention, Screening, and Treatment

• BRCA1 And BRCA2: Cancer Risk And Genetic Testing (National Cancer Institute)

• Breast Cancer Risk: Should I Have a BRCA Gene Test? (Healthwise)

• A Patchwork of Life-One Woman's Story, For Women Making Breast Cancer Treatment Decisions (Dan L. Duncan Cancer Center at Baylor College of Medicine)

• Adjuvant Endocrine Therapy For Hormone Receptor-Positive Breast Cancer (American Society of Clinical Oncology)

• Breast Cancer Screening And Dense Breasts: What Are My Options? (Healthwise)

• Breast Cancer Screening: When Should I Start Having Mammograms? (Healthwise)

• Breast Cancer Surgery (Option Grid Collaborative)

• Breast Cancer: Should I Have Breast-Conserving Surgery Or A Mastectomy For Early-Stage Cancer? (Healthwise)

• Breast Cancer: Should I Have Chemotherapy For Early-Stage Breast Cancer? (Healthwise)

• Breast Cancer: What Should I Do If I'm At High Risk? (Healthwise)

• BresDex: Breast Cancer Decision Explorer (Decision Laboratory, Cardiff University)

• Choosing Whether to Continue or Stop Mammography Screening At 70 (University of Sydney)

• Information On Mammography For Women Aged 40 And Older: A Decision Aid For Breast Cancer Screening In Canada (Public Health Agency of Canada)

• Making Decisions About Your Breast Cancer Treatment: A Decision Aid For Women with Early Breast Cancer (Department of Primary Care Medicine, Faculty of Medicine, University  of Malaya)

• Prophylactic Oophorectomy: Preventing Cancer by Surgically Removing Your Ovaries (Mayo Clinic)

• Reducing the Risk of Breast Cancer With Medicine: A Guide For Women (Agency for Healthcare Research and Quality)

• Should I Start Having Mammograms To Screen For Breast Cancer? (University of Sydney)

• Surgery Choices For Women With DCIS Or Breast Cancer (National Cancer Institute)

• Breast Cancer: Should I Have Breast Reconstruction After A Mastectomy? (Healthwise)

• Prophylactic Mastectomy: Breast Cancer Prevention For High-Risk Women (Mayo Clinic)Childhood Cancer Bone Marrow Transplantation

• Bone Marrow Or Blood Stem Cell Transplants in Children With Severe Forms of Autoimmune Disorders or Certain Types of Cancer (Agency for Healthcare Research and Quality)

Colorectal Cancer Screening

• Colon Cancer: Which Screening Test Should I Have? (Healthwise)

• Making Decisions: Should I Have a Screening Test for Bowel Cancer? (University of Sydney)

Cervical Cancer Screening

• HPV: Should I Get The Vaccine? (Healthwise)

• What Can You Do To Prevent HPV And Cervical Cancer? A Decision Aid For Parents/Guardians Of Girls In Grade 8 In Ontario (Ottawa Patient Decision Aid Research Group)

Head and Neck Cancer Treatment

• Understanding Radiotherapy For Head And Neck Cancer: A Guide For Adults And Their Caregivers (Agency for Healthcare Research and Quality)

Lung Cancer Screening and Treatment

• Lung Cancer Screening (Option Grid Collaborative)

• Stage IB, II, III Non-Small Cell Lung Cancer Cisplatin Plus Vinorelbine Chemotherapy After Surgery (American Society of Clinical Oncology)

• Stage IV Non-Small Cell Lung Cancer: First-Line Chemotherapy; Second-Line Chemotherapy; Second- Or Third-Line Chemotherapy with Erlotinib; Third-Line and Fourth-Line Chemotherapy: Decision Aid Set (American Society of Clinical Oncology)

Ovarian Cancer Prevention

• BRCA1 And BRCA2: Cancer Risk And Genetic Testing (National Cancer Institute)

• Breast Cancer Risk: Should I Have A BRCA Gene Test? (Healthwise)

• Oophorectomy for Risk of Ovarian Cancer-After The Menopause (Option Grid Collaborative)

• Oophorectomy for Risk of Ovarian Cancer-Before The Menopause (Option Grid Collaborative)

• Ovarian Cancer: Should I Have My Ovaries Removed To Prevent Ovarian Cancer? (Healthwise)

• Risk Management Options for Women at Increased Risk of Developing Ovarian Cancer (Prince of Wales Hospital)

Prostate Cancer Screening and Treatment

• Choosing the Radiation Dose in the Treatment of Prostate Cancer (Radboud University Nijmegen Medical Center)

• Decision Aid: Treatment Of Early-Stage Prostate Cancer (Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University)

• Knowing Your Options: A Decision Aid For Men With Clinically Localized Prostate Cancer (Agency for Healthcare Research and Quality)

• Localised Prostate Cancer-Low Risk (Option Grid Collaborative)

• ProsDex: A PSA Decision Aid (Decision Laboratory, Cardiff University)

• Prostate Cancer Risk Reduction With Finasteride: Discussion Guide For Doctor And Patient (American Society of Clinical Oncology)

• Prostate Cancer Screening With PSA Testing (American Society of Clinical Oncology)

• Prostate Cancer Screening: Should I Have A PSA Test? (Healthwise)

• Prostate Cancer Screening: Should You Get A PSA Test? (Mayo Clinic)

• Prostate Cancer: Should I Choose Active Surveillance? (Healthwise)

• Prostate Cancer: Should I Have Radiation Or Surgery For Localized Prostate Cancer? (Healthwise)

• Prostate Specific Antigen (PSA) Test (Option Grid Collaborative)

• PSA (Prostate Specific Antigen) Testing For Prostate Cancer: An Information Sheet For Men Considering A PSA Test (University of Oxford)

• Should I Have A PSA Test? (University of Sydney)

• Should You Get A PSA Test? A Patient-Doctor Decision (Virginia Commonwealth University)

• Treating Prostate Cancer: A Guide For Men With Localized Prostate Cancer (Agency for Healthcare Research and Quality)

• Treatment Choices For Men With Early-Stage Prostate Cancer (National Cancer Institute)

Testicular Cancer Treatment

• Testicular Cancer: Which Treatment Should I Have For Stage I Nonseminoma Testicular Cancer After My Surgery? (Healthwise)

• Testicular Cancer: Which Treatment Should I Have For Stage I Seminoma Testicular Cancer After My Surgery? (Healthwise)

Thyroid Cancer Screening

• Making Choices: Screening For Thyroid Disease (National Cancer Institute)

More than 1 million Americans are diagnosed with cancer each year. When faced with a cancer diagnosis, patients are often emotionally distressed and feel uncertain about their future. In addition, they must learn to deal with multiple health care professionals and complex treatments such as surgery, radiation, and chemotherapy. To navigate the course of cancer care, patients must be able to talk with doctors in a way that helps them understand choices for cancer treatment and cope with this serious disease.   

To best serve patients and achieve this goal, doctors must take a patient-centered approach that considers the patient’s needs and values, builds a strong relationship, and involves the patient in care decisions. Such an approach is known as patient-centered communication (PCC). PCC can help patients handle the emotional impact of the diagnosis, make sense of complex medical information, manage side effects and symptoms, make decisions about their care, deal with uncertainties, and adopt health-promoting behaviors.

Researchers have found a link between PCC and greater patient satisfaction, treatment adherence, and quality of life. Through continued review of PCC practices, researchers and practitioners can identify gaps in the quality of PCC and use that knowledge to improve interventions to help health care professionals communicate better with their patients.

Expanding What We Know about Patient-Centered Communication in Cancer Care

The burden of cancer demands that we understand and optimize how patients, families, and health care professionals communicate. But previous measures of patient–clinician communication have been limited by a lack of theoretical foundation and reduced scope. To address these gaps and measure PCC quality, RTI and our partners from the University of North Carolina at Chapel Hill and the patient advocacy group Fight Colorectal Cancer designed the Patient-Centered Communication in Cancer Care (PCC-Ca) instrument.

Available for public use, the PCC-Ca instrument is a tool for intervention research, national and regional population surveillance, and health care quality monitoring and assessment. The tool helps researchers determine whether and how improvements in PCC translate into better health outcomes by assessing how well health care professionals are communicating with their patients in six separate domains:

  • Exchanging information
  • Helping patients make decisions
  • Fostering healing relationships
  • Enabling patient self-management
  • Managing uncertainty
  • Responding to emotions.

These domains are based on the conceptual model of PCC described in the National Cancer Institute’s 2007 monograph, Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering. Thus, the PCC-Ca offers the advantage of being grounded in theory, as well as comprehensively representing different aspects of communication.

Combining Multidisciplinary Expertise, Qualitative Research, and Psychometric Analysis

To develop the PCC-Ca, we assembled a team of experts in health communication, cancer care, patient advocacy, psychometrics, and clinical medicine. Our team reviewed the literature to inform the development of an initial set of questions and conducted cognitive interviews with cancer patients to refine those questions. We fielded the survey items with 501 patients drawn from a statewide registry of cancer patients and conducted extensive psychometric analyses to develop a 36-item long form and a 6-item short form of the instrument. 

Publicly Available Tool for Researchers and Practitioners

Health care organizations, researchers, and practitioners can use the PCC-Ca for a variety of purposes, including evaluating interventions designed to improve PCC. The instrument can also be self-administered using a paper- or web-based survey. And the companion user guide provides scoring instructions, suggested uses, and other helpful information. 

The PCC-Ca team is excited to share this publicly-available, easy-to-use-tool with the hope of improving patient-physician communication, and ultimately health outcomes for people battling cancer.

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