Patient–professional communication research in cancer: an integrative review of research methods in the context of a conceptual framework

Authors

  • Linda E. Carlson,

    Corresponding author
    1. Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Cancer Board, Canada
    2. Department of Oncology, Faculty of Medicine, University of Calgary, Canada
    • Department of Psychosocial Resources, ACB Holy Cross Site, 2202 2nd St. S.W., Calgary, Alberta, Canada T2S 3C1
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  • Deb Feldman-Stewart,

    1. Cancer Research Institute, Queens University, Kingston, Canada
    2. Department of Oncology, Queens University, Kingston, Canada
    3. Department of Psychology, Queens University, Kingston, Canada
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  • Carol Tishelman,

    1. Department of Nursing, Karolinska Institutet, Sweden
    2. Stockholm Sjukhem Foundation, R&D Unit, Sweden
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  • Michael D. Brundage

    1. Cancer Research Institute, Queens University, Kingston, Canada
    2. Department of Oncology, Queens University, Kingston, Canada
    3. Department of Community Health and Epidemiology, Queens University, Kingston, Canada
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Abstract

This paper uses the conceptual framework of Feldman-Stewart et al. to organize and review the types of research methodologies used to investigate various aspects of patient-health care professional communication in the context of cancer. Research methods employed are classified as either non-experimental or experimental. Non-experimental designs include naturalistic observational studies (e.g. participant observation, audio- or videotaping of interactions) and retrospective introspective descriptions (e.g. self-report questionnaires, qualitative interview methods). Experimental designs often involve interventions aimed at improving communication, such as physician or patient training, and the use of technology to enhance communication (e.g. audiotapes, computers).

Using the conceptualization of the communication framework description, we argue that the outcome measures used in these studies address either primary goals, enabling goals, or secondary communication outcomes. Outcomes that are related to primary goals of the communication exchange include assessing the level of understanding of information conveyed, aspects of decision making, planning around treatments, or general provision of care. Outcomes related to enabling goals focus on elements that affect the ability to achieve primary goals. Outcomes secondary to the communication do not relate directly to what the communication is attempting to achieve. We conclude by identifying priority areas for further research, such as identifying the goals of both participants, understanding how particular aspects of the communication process affect their ability to achieve their goals, and examining the external environment in which communication takes place. Copyright © 2005 John Wiley & Sons, Ltd.

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