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Margaret Mclean

doi:10.3389/fpsyg.2011.00339

Abstract

This paper describes a study investigating the provider–patient communication perceptions, experiences, needs, and strategies of doctors and nurses working together in a UK cancer setting. This was a qualitative study using individual interviews and focus group discussions. Interpretative phenomenological analysis was used to underpin data collection and analysis. Twenty-six staff participated in the project (18 nurses and 8 doctors). Both professional groups identified an inherent emotional strain in their daily interactions with patients. The strategies they adopted to reduce this strain fell into two main categories: (1) Handling or managing the patient to keep negative emotion at bay; and (2) Managing self to keep negative emotion at bay. These strategies allowed staff to maintain a sense of control in an emotionally stressful environment. Most believed that their communication skills were sufficient. In conclusion, communicating with and caring for cancer patients causes considerable psychosocial burden for doctors and nurses. Managing this burden influences their communication with patients. Without recognition of the need for staff to protect their own emotional well-being, communication skills training programs, emphasized in current UK cancer care guidelines, may have little impact on practice.

Highlights

Good, patient-centered communication is significantly associated with patient satisfaction, reduced anxiety and depression, and increased quality of life (Thorne, 1999; Dowsett et al, 2000; Arora, 2003; Hack et al, 2005)
The aim of this study is to investigate the provider–patient communication perceptions, experiences, needs, and strategies of doctors and nurses working in a UK cancer setting
Data is presented by focus group or interview, with participants numbered within focus groups

Summary

Introduction

Patient-centered communication is significantly associated with patient satisfaction, reduced anxiety and depression, and increased quality of life (Thorne, 1999; Dowsett et al, 2000; Arora, 2003; Hack et al, 2005). Doctors and nurses often rely on their own judgment to assess patients’ needs (Arora, 2003; Hack et al, 2005) resulting in psychological morbidity and some physical symptoms, including the side-effects of treatment, being frequently under-recognized, and untreated (Ashbury et al, 1998; Maguire, 1999). Even when patients overtly disclose distress or physical complaints, staff frequently respond with avoidance or blocking behaviors (Wilkinson, 1991; Booth et al, 1996; Butow et al, 2002b). Staff ratings of patient quality of life and psychological distress are often inaccurate (Bredart et al, 2005)

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Conclusion