April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Clinicians Engaging Companions during Gynecologic Cancer Care
Rationale: Cancer diagnoses are overwhelming and distressing for patients and their families (National Cancer Institute, 2021). Due to illness severity, patients often attend oncology visits with a companion (Laidsaar-Powell et al., 2013), such as spouse, adult child, or friend. As such, clinicians may orient their communication to all present, including companions. Research on patient-centered communication describes how clinicians foster relationships and participation with patients; despite the common practice of companion presence and participation, little scholarship addresses how clinicians are inclusive of companions. This project examines clinician practices when engaging with patients and companions. Method: Ten clinicians were recruited from a National Cancer Center of Excellence in the Northeast United States. Participants were 9 female and 1 male clinician who identified as physicians (n = 4), medical assistants/technicians (n = 3), and nurse practitioners/registered nurses (n = 3) and in practice approximately 10 years (M = 9.77, SD = 8.59). Participants identified as approximately aged 40 (SD = 10.05) and as Caucasian (n = 4), Hispanic/Latinx (n = 2), Asian (n = 2), African American (n = 1), and mixed race (n = 1). Participants were interviewed and addressed issues about relationship building during treatment visits, such as “Tell me about how you first interact with patients and the people who accompany them?,” “How do you establish relationships?,” and “How do you typically interact with them [patients] and their support person(s)?” Participants received $100 gift card incentive. Interviews averaged 56 minutes (SD = 12.0) and were transcribed verbatim, verified, and deidentified. Two researchers engaged in thematic analysis to code emergent themes and characterize clinicians’ reports of relationship building (Brown & Clark, 2006). Results: Analyses revealed three themes that demonstrate how clinicians engage with patients and companions. Themes include creating a comfortable atmosphere for both patients and companions; utilizing companions in patient assessment; and prioritizing and protecting patients. Theme 1, creating a comfortable atmosphere, describes clinician efforts to help patients and companions relax and create a positive tone during medical visits. Clinicians are careful to orient to the patient and those accompanying the patient, asking for introductions. This theme also includes clinician encouragement of companion question asking and participation. Theme 2, utilizing companions in patient assessment, includes two subthemes; both serve to inform clinicians about patient wellbeing. The first subtheme, assessing patient emotional and cognitive processing readiness, describes how clinicians connect with companions to ensure patient understanding. Companion reactions assist clinicians in interpreting patient communication. The second subtheme, verifying patient information, discusses how clinicians rely on companion accounts to inform, clarify, supplement, or contradict patient accounts. The third theme, prioritizing and protecting the patient, describes the emphasis on patient voices and experiences during medical interactions. Clinicians shared a preference to first communicate with patients and then consider companion input. Clinicians also served to educate companions and buffer the patient from companion critique. Implications: The presence of companions influences how clinicians engage with patients. This study addresses ways clinicians mindfully address and engage companions when building patient relationships.