Communication is an important component of comprehensive cancer care impacting patient satisfaction, adherence, and quality of life. The wide array of issues addressed in cancer clinical interactions makes communicating about a broad range of topics (including quality of life, communication, symptom control, complementary/alternative therapies, costs, treatment burden, prognosis, anxiety, side-effects, sexual function, palliative care options, etc.) especially interesting and potentially challenging. Some of these topics may not be routinely addressed in the clinical interaction or may require consultative support from other members of the comprehensive cancer care team. One frequently overlooked critical element in research on communication between cancer clinicians, their patients, and their primary care clinicians is describing real-time consultations between patients and their clinicians. These interactions provide rich material for assessing key psycho-social dynamics and identifying issues that patients find important in their care. In order to devise systems of care that optimize the patient experience, it is critical that clinicians and researchers understand, appreciate, and systematically characterize the richness and complexity of the decision-making process in routine cancer consultations between cancer patients and their treating clinicians. This study seeks to assess the patient experience in cancer care by observing patients and their physicians in their clinical interactions and following them for several months to see how their care went. By describing in-depth the conversations and experiences of patients in these clinical interactions, this study will lay the foundation for practice-based interventions to optimize patients? interactions with their cancer care teams.
The proposed research addresses public health by rigorously assessing patient-clinician interactions in the context of an important public health problem -- cancer. Uncovering fundamental knowledge regarding topics that patients find important in their care, as well as key psychosocial aspects of communication between cancer patients and clinicians at all phases along the cancer control continuum will establish the necessary groundwork for interventions to improve cancer decisions in this area. This is relevant to the NIH's mission because it fosters fundamental creative behavioral discoveries in the delivery of cancer care using innovative research strategies that will be used to advance the quality of cancer care decision-making in the United States.