Chou Wen-Ying Sylvia, Falisi Angela L, Castro Kathleen, Ferrer Rebecca A, Gaysynsky Anna, Huang Grace C, Mollica Michelle A, Peterson Emily B, Kent Erin E
National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
ICF, 530 Gaither Road, Rockville, MD 20850, USA.
PEC Innov. 2022 Apr 20;1:100041. doi: 10.1016/j.pecinn.2022.100041. eCollection 2022 Dec.
There has been limited research to date exploring provider communication in the context of cancer clinical trials. To elucidate multidisciplinary care providers' experiences, this qualitative study sought to understand their perspectives and communication patterns around goals of care discussions with patients enrolled in cancer clinical trials.
Semi-structured key informant interviews were conducted with a purposive sample of physicians, nurse practitioners, social workers, chaplains, nurses, and administrative staff in a cancer research hospital (N=19). Data were analyzed and interpreted using thematic analysis.
Providers hold varied perspectives on goals of care in cancer clinical trials, highlighting the tension and potential for misalignment between scientific and clinical (patient-centered) goals. Inherent institutional hierarchies may impede some team members from initiating goal discussions. Care transitions (e.g., stopping treatment or initiating hospice) offer critical opportunities for goals of care discussions.
Conflicting perspectives among team members, perceptions of provider roles, and communication patterns could help explain some of the communication challenges previously documented in advanced cancer and clinical trial care.
This qualitative study contributes to the literature on healthcare team communication in the clinical trial context and highlights tangible opportunities to better leverage providers' diverse experience and improve patient-centered care.
迄今为止，在癌症临床试验背景下探索医疗服务提供者沟通情况的研究有限。为阐明多学科护理提供者的经历，这项定性研究旨在了解他们在与参加癌症临床试验的患者进行护理目标讨论时的观点和沟通模式。
对一家癌症研究医院的医生、执业护士、社会工作者、牧师、护士和行政人员进行了有目的抽样的半结构化关键信息人访谈（N = 19）。使用主题分析法对数据进行分析和解读。
医疗服务提供者对癌症临床试验中的护理目标有不同的看法，凸显了科学目标与临床（以患者为中心）目标之间的紧张关系和潜在的不一致。固有的机构层级可能会阻碍一些团队成员发起目标讨论。护理过渡（例如停止治疗或开始临终关怀）为护理目标讨论提供了关键机会。
团队成员之间相互冲突的观点、对医疗服务提供者角色的认知以及沟通模式，有助于解释先前在晚期癌症和临床试验护理中记录的一些沟通挑战。
这项定性研究为临床试验背景下医疗团队沟通的文献做出了贡献，并突出了切实可行的机会，以更好地利用医疗服务提供者的多样经验并改善以患者为中心的护理。
