Communication and Education Needs for Best Practice in Inpatient Cancer Rehabilitation

Abstract

<h3>Research Objectives</h3> To assess therapists' level of comfort, confidence, and education needs when engaging in patient-centered care in an inpatient cancer rehabilitation program. <h3>Design</h3> A prospective quality improvement study using a concurrent mixed-method design. <h3>Setting</h3> An inpatient rehabilitation hospital. <h3>Participants</h3> Sixty-seven therapists completed surveys and a subsample of 11 therapists participated in two focus groups to provide feedback about their readiness to engage in patient-centered communication in an inpatient cancer rehabilitation program. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Descriptive statistics summarized the therapists' demographic characteristics, level of comfort, confidence, and education needs. Focus group data was coded using a thematic coding scheme. Coded text was compiled into a rapid analysis matrix. <h3>Results</h3> Preliminary survey results indicate only 31.1% of therapists reported comfort discussing end-of-life concerns with their cancer patients, and 81.0% of therapists recommended more education on navigating challenging conversations. Common communication themes were noted across cancer patients' length of stay including prognosis discussion, end-of-life, and discharge planning. Therapists also specified communication barriers and facilitators they experienced while engaging in patient-centered conversations with cancer patients and their families during inpatient rehabilitation. <h3>Conclusions</h3> Similar findings from the survey and focus groups contextualized different barriers and facilitators of patient-centered communication in an inpatient cancer rehabilitation program. When prognosis is clear and understood, the therapy team can successfully plan for the patient's current and future functional status as well as equipment and family training needs. Ongoing education and use of a communication aid, such as a Question Prompt List, can support improved communication in inpatient cancer rehabilitation. <h3>Author(s) Disclosures</h3> The authors are salaried employees of Kessler Institute for Rehabilitation and Kessler Foundation.