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Communication problems with clinicians can harm cancer patients, study finds


Healthcare providers must do a better job of monitoring communication between cancer patients and their physicians, according to a recent study that found a failure to do so can contribute to a breakdown in care.

In a study published online by the Journal of Clinical Oncology, researchers said patients often experience communication problems with their providers that caused a “preventable, harmful event” during their cancer diagnosis or care.

However, very few patients report their concerns, making it difficult for healthcare providers to respond effectively.

The study involved telephone interviews with 416 patients at three clinical cites. Ninety-three patients reported that something had happened in their care that caused or could have caused harm, including physical and emotional harm, a negative effect on family, a damaged physician–patient relationship and financial expense.

Of the 78 patients who completed interviews with the researchers, 28 percent described a problem with medical care, such as a delay in diagnosis or treatment; 47 percent said they experienced problems with the information exchanged with the provider or the manner in which it was conveyed; and 24 percent described problems with medical care as well as communication.

The investigators reported that “few clinicians initiated discussion of the problematic events” and that only 13 percent formally reporting a problem. About 90 percent of the patients interviewed said their experiences prompted them to become more involved in their treatment by asking more questions or researching symptoms and treatments on their own. About 10 percent reported that they became more hesitant to seek care because of their experiences.

Kathleen M. Mazor, associate professor of medicine at the University of Massachusetts School of Medicine and lead author of the study, said the findings suggest patients are often more willing to share their concerns with nurses rather than directly addressing them with their doctors.

“We suspect that if nurses explicitly let patients know that they wanted to know about patients' questions and concerns, they could play an even more active role in reducing the sorts of breakdowns we identified,” Mazor said.

The study was a project of the Cancer Research Network’s Cancer Communication Research Center, which is funded by the National Cancer Institute.