Abstract
Aim: To illuminate the processes of communication between healthcare professionals, patients and informal carers during oral cancer drug therapy in order to identify factors that promote or inhibit concordance and appropriate medication administration.
Background: Communication about medications can be one-sided, leaving the patient to take a passive role in discussions about medications. In relation to oral chemotherapy, there is a paucity of research in this area, which is surprising given the extremely narrow therapeutic index of oral chemotherapy and subsequent high risk of toxicity (Mitchell et al. 2014).
Design: A critical ethnographic design was undertaken incorporating observations, semi-structured interviews and focus-groups as data collecting methods.
Methods: Over 60 hours of observational data was digitally recorded from interactions between fifteen healthcare professionals and eight patients over a period of six months in outpatient departments within one hospital in Northern Ireland (Mitchell et al. 2015). In addition, semi-structured interviews were conducted with patients during and after their treatment. Focus-groups were carried out with healthcare professionals at the conclusion of the study. These data were analysed using thematic analysis.
Results: The key themes that emerged from the patient journey related to the uncertainty of prognosis, healthcare professional prioritisation of the medical management of side-effects, the emergence of patient-led communication processes, patient regimen adherence challenges and post-treatment isolation.
Discussion: This study found that the main communication priority for patients, their family members and healthcare professionals, was medical management of side-effects. Communication about oral chemotherapy is an extremely important area in relation to management of patient safety and maintenance of one’s psychological and social needs. Importantly, communication about oral chemotherapy is not an isolated event. It occurs over a long period, is preceded by important communication processes through the diagnosis period and succeeded by supportive communication in the period after treatment.
Background: Communication about medications can be one-sided, leaving the patient to take a passive role in discussions about medications. In relation to oral chemotherapy, there is a paucity of research in this area, which is surprising given the extremely narrow therapeutic index of oral chemotherapy and subsequent high risk of toxicity (Mitchell et al. 2014).
Design: A critical ethnographic design was undertaken incorporating observations, semi-structured interviews and focus-groups as data collecting methods.
Methods: Over 60 hours of observational data was digitally recorded from interactions between fifteen healthcare professionals and eight patients over a period of six months in outpatient departments within one hospital in Northern Ireland (Mitchell et al. 2015). In addition, semi-structured interviews were conducted with patients during and after their treatment. Focus-groups were carried out with healthcare professionals at the conclusion of the study. These data were analysed using thematic analysis.
Results: The key themes that emerged from the patient journey related to the uncertainty of prognosis, healthcare professional prioritisation of the medical management of side-effects, the emergence of patient-led communication processes, patient regimen adherence challenges and post-treatment isolation.
Discussion: This study found that the main communication priority for patients, their family members and healthcare professionals, was medical management of side-effects. Communication about oral chemotherapy is an extremely important area in relation to management of patient safety and maintenance of one’s psychological and social needs. Importantly, communication about oral chemotherapy is not an isolated event. It occurs over a long period, is preceded by important communication processes through the diagnosis period and succeeded by supportive communication in the period after treatment.
| Original language | English |
|---|---|
| Publication status | Accepted - 14 Jan 2018 |
| Event | Royal College of Nursing 2018 International Research Conference - Duration: 16 Apr 2018 → 18 Apr 2018 |
Conference
| Conference | Royal College of Nursing 2018 International Research Conference |
|---|---|
| Period | 16/04/2018 → 18/04/2018 |
Keywords
- Cancer
- Chemotherapy
- Communication
- Ethnography
- Qualitative Research
