Health Care Experiences Research Articles

“My support groups… have saved my life.”: facilitators of positive or satisfactory experiences in behavioral healthcare for transgender and gender nonconforming older adults

Objectives Transgender and gender nonconforming (TGNC) older adults experience significant behavioral health and healthcare disparities. Facilitators that contribute to positive behavioral healthcare experiences among this population, however, remain uncertain. In this study, we investigate facilitators contributing to positive or satisfactory behavioral healthcare experiences among a sample of TGNC older adults in the United States (US). Method Between September 2021 and January 2022, the first author conducted 47 semi-structured, individual interviews with TGNC adults aged 65 years or over in the US. Using an inductive grounded theory approach, we examined respondents’ positive or satisfactory experiences with accessing and utilizing behavioral health services, support, and resources. Analyses were conducted using NVivo (Release 1.6) software. Results Findings underscore the importance of addressing the specific or unique needs of TGNC older patients to promote positive or satisfactory experiences in behavioral healthcare. Three themes emerged: (1) engaging with behavioral healthcare practitioners who offer compassionate, patient-centered care; (2) accessing and utilizing culturally tailored peer-support groups; and (3) receiving equitable access to gender-affirming care and social services. Conclusion These findings highlight opportunities for expanding and incorporating these identified facilitators into behavioral healthcare research and practice, especially when promoting gender affirmation in care for TGNC older patients.

'It's Just Not Working', a Qualitative Exploration of the Weight-Related Healthcare Experiences of Individuals of Arab Heritage With Higher Weight in Australia.

Culturally and linguistically diverse population groups disproportionately experience higher weight and other non-weight-related discrimination in healthcare settings outside of their ancestral country. Little is known about the experiences of individuals with Arab heritage. This study aimed to qualitatively explore the intersectional weight-related healthcare experiences of individuals of Arab heritage with higher weight in Australia. A general inductive enquiry approach was used. Purposive, convenience and snowball sampling was used to recruit individuals of Arab heritage residing in Australia. Individuals were invited to participate in an online semistructured interview. Interviews were recorded, transcribedand thematically analysed. Fifteen participants took part in the study. Of these participants, 93% were female (n = 14), 80% were aged between 18 and 44 years (n = 12), 73% were university educated (n = 11), 53% were born outside of Australia (n = 8)and all were Muslim (n = 15). Four main themes were identified: (1) appearance-based judgement, (2) generalised advice and assumptions, (3) cultural responsivenessand (4) healthcare system constraints. Individuals of Arab heritage with higher weight in Australia, namely, females, often perceive their healthcare experiences as dismissive of their cultural and religious needs and driven by causality assumptions around weight. It is crucial that care delivered encompasses cultural humility, is weight-inclusiveand acknowledges systemic constraints. Cultural safety training benchmarks, healthcare management reformand weight-inclusive healthcare approaches are recommended to assist healthcare providers in delivering effective, holisticand culturally safe care. Insights gained from conversations with Arab heritage community members with lived experiences regarding weight-related healthcare encounters informed the study design and approach.

Medical tourist perceptions of hospitality across cultures

PurposeThis study aims to explore how the treatment, well-being and satisfaction of health tourists are affected by what is characterized as the hospitality culture of health care.Design/methodology/approachA qualitative research design focusing on in-depth semi-structured interviews was conducted with 28 Omani health tourists who visited Iran and received health-care services. Data were analyzed thematically using ATLAS.ti software.FindingsThe results revealed that a caring health professional is essential for patient healing and well-being. Cultural congruence is enhanced through effective communication between patients and health-care service providers. Additionally, a hospitality-certified workforce is essential for customer satisfaction and overall well-being. Finally, a hospitality-style approach and home-like atmosphere improve patient rehabilitation and performance.Research limitations/implicationsThe study’s exclusive focus on Omani health tourists necessitates caution in generalizing findings. Future research could encompass more diverse populations and inclusive samples to broaden applicability.Practical implicationsThe study highlights the key role of hospitality culture in the health-care sector, emphasizing the significance of building a culturally sensitive and hospitable environment to improve patient satisfaction and overall well-being. This includes the creation of welcoming environments and customized health-care experiences congruent with patients’ cultural values and beliefs.Originality/valueThe study emphasizes the crucial role of hospitality culture in health tourism and the potential to create a culture of care and respect in health-care settings, addressing patients’ holistic needs beyond physical amenities and enriching the patient experience. It also applies Leininger’s Culture Care Theory to hospitality, providing a novel viewpoint on culturally congruent, safe and meaningful care for health tourists.

Brilliant care: a conceptual argument for scholarship of the extraordinary

ABSTRACT Critiques of healthcare often focus on negative experiences to address gaps, issues, and problems. While important, this often obscures care that exceeds expectation – that is, brilliant care. This article centres brilliant care by considering the questions that might be asked to surface it, and what might happen when brilliant care is centred. Specifically, a conceptual understanding of brilliant care is extended within health sociology. In doing so, the article draws on Mol’s research on the logic of care, Fredrickson’s broaden-and-build theory, and Hochschild’s notion of emotion work. Through an application of this conceptual framework to secondary data – namely, reported stories of healthcare experiences from the series ‘What’s right in health care’ – the article demonstrates how the framework surfaces and illuminates aspects of brilliance and its emergence. The article concludes by considering the implications this has on how we make sense of healthcare and the positive, social, and relational aspects that might be surfaced in current and future practices.

O-317 Recurrent miscarriage and infertility : a qualitative study of views and experiences of services in the republic of Ireland

Abstract Study question How do women with recurrent miscarriage (RM) and infertility and healthcare professionals view and experience services and supports? Summary answer RM and infertility is a complex experience, intensified by divisions within the Irish healthcare system and a lack of knowledge and awareness around reproductive health What is known already While services for recurrent miscarriage (RM) are gradually improving with increasing awareness, women with RM and infertility have received limited attention in research and clinical guidance internationally. RM and infertility are separately associated with psychological distress and adverse pregnancy outcomes. Moreover, the dual experience is devastating for women and couples, and the optimal supports remain unidentified. Identifying the needs of this cohort is especially pertinent in the Republic of Ireland as public fertility care expands to include assisted reproductive technologies, previously only available through private or not-for-profit fertility clinics. Study design, size, duration We undertook a qualitative semi-structured interview study using a Reflexive Thematic Analysis approach. Thirty-three interviews were conducted, virtually on MIcrosoft Teams and in-person, between Dec 2022 and May 2023. These were audio-recorded, and data transcribed to NVivo12 for subsequent analysis. Participants/materials, setting, methods We recruited healthcare professionals delivering RM and/or fertility services, and women who experienced two or more consecutive miscarriages in the last four years and had undergone fertility care, through our professional networks and social media. Purposive sampling was used to include diverse perspectives across disciplines, public and private sectors, lived experiences and geographical locations. Interviews were audio-recorded, and data transcribed for subsequent reflexive thematic analysis. Main results and the role of chance We interviewed 16 healthcare professionals and 17 women with lived experience. Women were aged 35-47 and had experienced two to nine miscarriages. All received fertility care in ROI, with some additional care abroad. Healthcare professionals included four Clinical Midwifery Specialists in Bereavement eight Consultants and four Clinical Nurse Specialists in Fertility. We actively generated four themes during data analysis. (1) “Exploring all avenues”- women sought the best care and information, but their search was hindered by stigmatisation, definitions of RM and misinformation. (2) “Exhausting all resources” - women wanted to ensure they had tried everything to have a baby, investing all physical, emotional and financial reserves (3) “Separateness” - women feel remote from others who have not experienced RM or infertility and removed from both maternity and fertility services, as well as caught between public and private systems. (4) “No woman is an island” - supports come from multiple sources in their lives and in various guises but are limited, especially psychological supports. Limitations, reasons for caution This was a sample of white, educated, professional women with access to private fertility services. While a diverse group of HCPs were interviewed with current and past clinical experiences of private fertility services, there was limited engagement from fertility care providers. Wider implications of the findings This study identifies areas for improvement, such as access to investigations and supports, as well as the experiences and specific care and support needs of women/couples experiencing RM and infertility. Issues such as women’s awareness of their reproductive health, and equity in services, are applicable to all maternity service users. Trial registration number N/A

Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis.

The perinatal period is known as time of transition and anticipation. For women with social risk factors, child protection services may become involved during the perinatal period and this might complicate their interactions with healthcare providers. To systematically review and synthesise the existing qualitative evidence of healthcare experiences of women and healthcare professionals during the perinatal period while facing child protection involvement. A systematic search of databases (Web of Science, MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, MIDIRS, Social Policy and Practice and Global Health) was carried out in January 2023, and updated in February 2024. Quality of studies was assessed using the Critical Appraisal Skills Programme. A Critical Interpretative Synthesis was used alongside the PRISMA reporting guideline. A total of 41 studies were included in this qualitative evidence synthesis. We identified three types of healthcare interactions: Relational care, Surveillance and Avoidance. Healthcare interactions can fluctuate between these types, and elements of different types can coexist simultaneously, indicating the complexity and reciprocal nature of healthcare interactions during the perinatal period when child protection processes are at play. Our findings provide a novel interpretation of the reciprocal interactions in healthcare encounters when child protection agencies are involved. Trust and transparency are key to facilitate relational care. Secure and appropriate information-sharing between agencies and professionals is required to strengthen healthcare systems. Healthcare professionals should have access to relevant training and supervision in order to confidently yet sensitively safeguard women and babies, while upholding principles of trauma-informed care. In addition, systemic racism in child protection processes exacerbate healthcare inequalities and has to be urgently addressed. Providing a clear framework of mutual expectations between families and healthcare professionals can increase engagement, trust and accountability and advance equity.

P-462 Exploring the potential of fertility clinics in the metaverse: opportunities, challenges, and ethical implications

Abstract Study question Could the integration of the metaverse enhance patient care in fertility clinics, and what are its potential challenges and ethical implications? Summary answer Integrating the metaverse into fertility care could enhance assisted reproduction, improving patient and provider experiences. However, it presents challenges in privacy, accessibility, and ethical implications. What is known already The digital transformation in healthcare, accelerated by the COVID-19 pandemic, has underscored the potential of the metaverse in medical fields. Utilising technologies such as virtual reality (VR), augmented reality (AR), and mixed reality (MR), the metaverse offers significant opportunities for enhancing patient care, engagement, medical training, and support. Its applications across various medical disciplines demonstrate its capacity to improve healthcare experiences. However, the specific implementation of the metaverse in fertility clinics, aimed at meeting the distinct expectations of tech-savvy Millennials and Generation Z, and potentially enhancing patient experience, treatment efficacy, and support mechanisms, is yet to be explored. Study design, size, duration Conducted in November and December 2023, this systematic literature review ensured a focused and up-to-date analysis of the current applications and implications of the metaverse in healthcare. This review spanned major databases, leading ART journals, and pertinent industry reports. Over two months, 468 metaverse-related publications, from 2007-2024, were identified, with 81 addressing healthcare (2022-2024). However, only one paper specifically addressed ART in the context of IVF metaverse clinics, indicating a significant research gap. Participants/materials, setting, methods This study involved analysis of academic literature, industry reports, and real-world implementations to assess the metaverse’s current use in healthcare. Research keywords included ‘metaverse’, ‘healthcare’, ‘(in)fertility’ and ‘assisted reproduction’, focusing on present and potential metaverse applications in healthcare provision, advanced patient care technologies, innovative training methodologies, and practical uses in clinical settings. Additionally, it scrutinised challenges and ethical issues associated with metaverse technology and existing platforms, providing a comprehensive overview of its implications in healthcare. Main results and the role of chance Current applications of the metaverse in healthcare are evident in specialties such as urology, mental health, ophthalmology, chronic pain management, cancer, and paediatrics. Innovative technologies, including haptic tools and smart operating theatres, have enabled the development of complex surgical techniques and practices. Metaverse conferences featuring avatar delegates introduced a new dimension to professional interactions. Digital twins are used to simulate patient scenarios, enabling personalised treatment plans that improve the accuracy of diagnoses and treatments. In medical and nursing education, VR offers immersive, hands-on learning experiences. In the context of ART, the metaverse holds promise for enhancing telemedicine through AI-driven avatars, advanced patient monitoring, and haptic simulation training for procedures like egg collections, embryo transfer, and ICSI. Patients may experience immersive virtual tours of typically restricted laboratory areas, interact with digital representations of their embryos, and engage in immersive online support communities. However, significant challenges persist, including the maintenance of patient privacy, addressing technological disparities, and managing billing complexities in virtual environments. The study emphasises the critical importance of data privacy and security, particularly concerning the sensitivity of fertility-related information. Additionally, it raises questions about the authenticity of patient-provider interactions in a virtual setting and the potential for deepening digital divide. Limitations, reasons for caution The study’s limitations include a scarcity of literature on the metaverse in future fertility clinics, as evidenced by just one online paper addressing IVF metaverse clinics. This gap limits a comprehensive understanding of the metaverse’s applications in ART, and raises concerns about consistent and secure access to these emerging technologies. Wider implications of the findings This research highlights the transformative potential of the metaverse in fertility care, emphasising focused research, ethical considerations, and infrastructure development to harness its benefits. Highlighting the importance of navigating challenges such as data privacy, technological disparities, and regulatory frameworks to ensure optimal patient care in this evolving digital landscape. Trial registration number not-applicable

Understanding the Retrospective and Current Health Care Needs and Service Experiences of Adult Survivors of Minor Sex Trafficking

Minor sex trafficking is an urgent public health problem, but we lack data about how such experiences impact health and health care access. Utilizing data collected from in-depth interviews with 35 adult survivors of minor sex trafficking across the U.S. we explored the physical and psychological healthcare access and healthcare experiences of adult survivors of minor sex trafficking. Negative healthcare experiences before, during, and following sex trafficking foster a lack of trust and confidence in healthcare systems as adults. Recommendations are provided to help overcome barriers to meeting healthcare needs and improving health care experiences for survivors of minor sex trafficking.

Consultations With Muslims From Minoritised Ethnic Communities Living in Deprived Areas: Identifying Inequities in Mental Health Care and Support.

Limited research concerning existing inequities in mental health care and support services in the United Kingdom captures perceptions and lived experiences of the significantly underrepresented Muslim population. Underpinned by social constructivist theory, we used consultation to facilitate public and patient involvement and engagement (PPIE) to identify inequities in mental health care and support experienced by Muslims from minoritised ethnic communities living in deprived areas in Liverpool, UK. The rationale was to (a) better inform standards and policies in healthcare and (b) provide a psychologically safe space to members of the Muslim community to share perceptions and experiences of mental health care and support services. To ensure trustworthiness of the data, member checking was adopted. This paper describes the procedure to achieving this consultation, including our recruitment strategy, data collection and analysis as well as key findings. Twenty-seven consultees attended the women's consultation and eight consultees attended the men's consultation. Consultees were from Yemeni, Somali, Sudanese, Egyptian, Algerian, Pakistani and Moroccan communities and share the Islamic faith. Four key interlinked themes were identified from consultees' narratives: (1) broken cycle of trust; (2) an overmedicalised model of care; (3) community mental health prevention initiatives; and (4) culturally conscious training and education. The Muslim population has identified numerous barriers to accessing mental health support and there is a need to resource activities that would aid deeper understanding of mental health support needs through continuous and meaningful community initiatives. This would afford mental health practitioners and organisations opportunities for developing realistic anti-racism strategies, effectively adopting social prescription, strengthening partnerships and collaborations aimed at supporting delivery of evidence-based mental health care provisions to tackle mental health inequities. This paper reports on the involvement and engagement of Muslims from minoritised ethnic communities living in the Liverpool city region.

Contextualising and challenging under-representation in research in light of Cultural Trauma: a qualitative focus group and interview study

BackgroundAlthough underserved populations— including those from ethnic minority communities and those living in poverty—have worse health and poorer healthcare experiences, most primary care research does not fairly reflect these groups. Patient and public involvement (PPI) is usually embedded within research studies in the United Kingdom (UK), but often fails to represent underserved populations. This study worked with patient and public contributors and local community leaders, situated in a socio-economically deprived and ethnically diverse urban area, to explore under-representation in primary healthcare research.MethodsWe undertook a focus group with a purposive sample of 6 members of a Patient and Public Involvement Group (PPIG), and interviews with 4 community leaders (representing Black, South Asian, Roma and socio-economically deprived communities). An iterative analysis process based on template analysis was used. Focus group 1 was rapidly analysed, and a template created. Findings were presented in focus group 2, and the template further developed. The Cultural Trauma concept was than applied to the template to give a wider theoretical lens. In-depth analysis of focus groups and interviews was then performed based on the template.ResultsWider societal and historical influences have degraded trust in academic and healthcare institutions within underserved populations. Along with more practical considerations, trust underpins personal motivations to engage with research. Researchers need to invest time and resources in prolonged, mutually beneficial engagement with communities of importance to their research, including sharing power and influence over research priorities. Researcher reflexivity regarding differential power and cultural competencies are crucial. Utilising participatory methodologies including co-production demonstrates a commitment to inclusive study design.ConclusionsRe-framing evidence-based medicine to be more useful and relevant to underserved populations with the highest burden of ill health is urgently needed. Lack of representation in primary healthcare research reflects wider societal inequalities, to which Cultural Trauma provides a useful lens. However, there are actions that researchers can take to widen representation. This will ultimately help achieve the goal of increased health equity by enhancing scientific rigour and research generalizability.

Qualitative interview with mothers of moderately or late preterm infants in the UK: where are the care gaps?

IntroductionPreterm birth (<37 gestational weeks) accounts for an increasing proportion of global births each year, with moderately or late preterm birth (MLPT) (32+0/7–36+6/7 gestational weeks) comprising over 80% of all...

German Translation and Linguistic Validation of the LIMB‑Q: A Patient-reported Outcome Measure for Lower Extremity Trauma.

Lower extremity trauma can have a significant impact on a patient's quality of life. The LIMB-Q is a recently developed and validated patient-reported outcome measure that assesses patient-specific outcomes and experience of health care. The aim of this study was to translate and linguistically validate the LIMB-Q from English to German. The translation was performed by combining World Health Organization and Professional Society for Health Economics and Outcomes Research guidelines. The process consisted of forward translations, a backward translation, expert panel meetings, cognitive debriefing interviews with patients, and several rounds of discussion and reconciliation with the creators of LIMB-Q. The goal was to obtain a culturally and conceptually accurate translation of LIMB-Q into German for use in Switzerland. From the two forward translations, there was one primary discrepancy between the two translators that was discussed to determine the most conceptually accurate translation. From the backward translations, there were 63 items that required discussion and re-translation. Nine patients participated in the cognitive debriefing interviews, which led to three items being modified. The translation process led to a linguistically validated and conceptually equivalent German version of the LIMB-Q. The German (Switzerland) version of LIMB-Q is now available. This will offer a valuable tool for lower extremity trauma research and clinical care in German-speaking populations.

What does good care look like to people living with congenital heart disease in the 21st century? Qualitative online, asynchronous discussion forums

ObjectivesAs part of a wider study, our aim was to elicit perspectives of people with congenital heart disease (CHD) and/or their parents/carers about their experiences of healthcare and what is...

Revisiting organizational culture in healthcare: Heterogeneity as a resource

Aligning culture to be similar across work units is a common organizational tactic, but its appropriateness for the multidisciplinary context of healthcare is far from certain. Variation in perceptions of culture across large health systems may serve a functional purpose in delivering high quality care and ameliorating job stress; however, past research in healthcare has focused on culture as the average set of values and norms (i.e., cultural content) rather than on (dis)agreement about values and norms among organizational members (i.e., cultural structure). This survey-based study examines both cultural content (averages among individuals) and structure (distances between individuals) in departments of a large U.S. healthcare organization (total sample = 26,314 workers, response rate = 84%). We used linear models to associate four commonly used culture measures with outcome measures (perceived care quality, intent to stay, and manageable job stress). We found substantial heterogeneity in perceptions for multiple culture types. We found curvilinear relationships between heterogeneity for all culture types and outcomes, suggesting that heterogeneity promotes positive outcomes up to a certain point after which the positive effect declines. For research, our findings point to the importance of studying culture in healthcare with greater focus on heterogeneity; for practice, this study highlights how culturally-focused efforts to improve care quality and worker experience in healthcare should be more precise about balancing cultural alignment and heterogeneity.

Centring children's lived experiences in understanding the importance of play in hospitals.

Children have a right to participate in matters affecting their lives. With increasing regularity, children's perspectives are being sought regarding their health and health care experiences. Though there is evidence that children find play to be one of the 'best' aspects of hospitalisation, studies rarely focus on children's perspectives on play in hospital. This qualitative study explored children's lived experiences of play during hospitalisation. Over five months, ethnographic observations were conducted on a paediatric oncology ward as well as interviews with 16 children ages 3-13 years. Using interpretative phenomenological analysis, children's expressions and experiences illuminated three key points: safety and comfort are integral to children feeling able to play in hospital; the value and efficacy of play is decided by children; and that play is a way for patients to be (and be treated as) children first. Hospitals can only be child-friendly if children find them friendly. Listening to and integrating children's perspectives in the discourse around the importance of play in hospital is essential for respecting children's rights and delivering person-centred paediatric healthcare.

Developing integrated person-centered care quality indicators for home health agencies in Shanghai, China: A modified Delphi-analytic hierarchy process study

ObjectivesTo develop person-centered integrated care quality indicators for home health agencies in Shanghai, China. DesignThe study combined the Delphi method and the analytic hierarchy process (AHP). Material and methodsThe Delphi consultation questionnaire was distributed to experts in home healthcare in Shanghai, China. A panel of experts with experience in home healthcare in Shanghai, China, was selected. Purposive sampling was used to choose experts. In this study, ten experts were selected from within sub-fields of home healthcare, including nursing, health policy, quality improvement, person-centered care (PCC), and integrated care. ResultsThe authority coefficient (Cr) in this study was 0.835. The coordination degree of experts’ opinions, which is expressed by Kendall coordination coefficient W (a higher value, better coordination of the item), ranged from 0.352 to 0.386 (p < 0.001). The consistency ratio (CR) values for each level were less than 0.1. The quality indicator system included three first-level indicators, 15 second-level indicators, and 56 third-level indicators. ConclusionsA person-centered integrated care quality indicator system was developed for home health agencies. The findings from this study enable nurses, managers, and policymakers in home and community-based settings to evaluate person-centered integrated care quality using a robust framework. In addition, these indicators can also be used as a standardized tool to guide the development of long-term care services and supports (LTSS) for home-bound elderly.

Population assessment of health system performance in 16 countries.

To demonstrate how the new internationally comparable instrument, the People's Voice Survey, can be used to contribute the perspective of the population in assessing health system performance in countries of all levels of income. We surveyed representative samples of populations in 16 low-, middle- and high-income countries on health-care utilization, experience and confidence during 2022-2023. We summarized and visualized data corresponding to the key domains of the World Health Organization universal health coverage framework for health system performance assessment. We examined correlation with per capita health spending by calculating Pearson coefficients, and within-country income-based inequities using the slope index of inequality. In the domain of care effectiveness, we found major gaps in health screenings and endorsement of public primary care. Only one in three respondents reported very good user experience during health visits, with lower proportions in low-income countries. Access to health care was rated highest of all domains; however, only half of the populations felt secure that they could access and afford high-quality care if they became ill. Populations rated the quality of private health systems higher than that of public health systems in most countries. Only half of respondents felt involved in decision-making (less in high-income countries). Within countries, we found statistically significant pro-rich inequalities across many indicators. Populations can provide vital information about the real-world function of health systems, complementing other system performance metrics. Population-wide surveys such as the People's Voice Survey should become part of regular health system performance assessments.

Standardized Patient Encounter to Enhance Care to LGBTQIA+ Patients

Context Athletic trainers provide care for a variety of patients with diverse backgrounds, including members of the lesbian, gay, bisexual, transgender, queer, intersex, other diverse sexualities, other gender identities, or other gender expressions (LGBTQIA+) community. Learners who gain experience with patients who identify as LBGTQIA+ should be better prepared clinicians. Objective The purpose of this paper is to describe a standardized patient (SP) experience for a patient who is gay and concerned about a sexually transmitted infection after a conversation with a previous partner. Background Patients who identify as LGBTQIA+ report substandard care and have poor health care experiences. Standardized patients are used in athletic training education as a method to teach and assess skills and can be used to improve the care that learners provide to patients who identify as gay. Educational Advantage Education drives clinical practice, and incorporating SP cases in which learners must provide care for a patient who is gay will help the learners provide better inclusive patient-centered care as a clinician. Conclusions Faculty may consider using a SP encounter to better prepare learners to provide care for a patient who is gay.

A small surprise with a big impact on patient engagement

A patient’s journey into endocrinology is shaped by a welcoming note on the examination table, symbolizing compassionate care and easing anxiety. The doctor’s collaborative demeanour, characterised by attentive engagement and openness to new ideas, fosters a partnership based on trust. This perspective encourages medical professionals to embrace humility, curiosity, and mutual respect, enhancing healthcare experiences and outcomes. Such practices require no significant investment but yield profound benefits in building equitable doctor-patient relationships and improving overall healthcare quality.

Healthcare Communication Experiences of Hispanic Caregivers of Childhood Cancer Survivors.

Interpersonal communication is a crucial component of the cancer experience that can contribute to managing cancer care and improving cancer survivors' and caregivers' quality of life. Cultural and contextual factors may impact Hispanic childhood cancer survivor (CCS) and parent caregiver relationships and communication. This study sought to describe the healthcare communication experiences of Hispanic parents with CCS, families, and medical providers. We conducted 15 semi-structured interviews with Hispanic caregivers from a safety-net hospital in Los Angeles County. Interviews were conducted in English and Spanish, audio-recorded and professionally transcribed, and analyzed using a thematic approach. Caregivers shared the importance and impact of medical communication when exploring the "first big talk" of the diagnosis, uncertainty about treatment, navigating multiple providers, therapeutic communication (i.e., providing emotional reassurance), and current and lingering effects of cancer. All caregivers shared "good communication" experiences, while others shared various barriers to communication, including a lack of understanding of the cancer diagnosis and caregiver experience, psychological challenges impacting communication, cultural and language differences, physical factors that limit communication, and young age of child impacting communication with caregivers. Our findings suggest that a strong interpersonal communication skill set for clinicians can contribute to managing cancer care and improving caregivers' psychological adjustment.