Journal
JOURNAL OF CANCER SURVIVORSHIP
Volume 10, Issue 1, Pages 153-163Publisher
SPRINGER
DOI: 10.1007/s11764-015-0461-z
Keywords
Decision-making; Safety-net; Lung cancer; Qualitative methods; Patient-physician communication
Categories
Funding
- National Cancer Institute [5R03CA159706-02]
- UT Southwestern Center for Patient-Centered Outcomes Research from the Agency for Healthcare Research and Quality [R24 HS022418]
- UTSW Center for Translational Medicine, through the NIH/National Center for Advancing Translational Sciences [UL1TR001105]
- Harold C. Simmons Cancer Center [1P30 CA142543]
Ask authors/readers for more resources
We explored patient-perceived role in decision-making related to active treatment and palliation among African Americans receiving lung cancer care through a county safety-net system. Drawing from a cohort of over 100 African Americans treated in a safety-net hospital, we invited a subsample of 13 patient-caregiver dyads to participate in a series of dyadic, ethnographic interviews conducted at the patients' homes. Over 40 h of transcripts were analyzed in an iterative process resulting in reported themes. Findings from ethnographic interviews demonstrated that healthcare communication with physicians is difficult for patients. While caregivers and patients describe a deep engagement in lung cancer care, they expressed a concurrent lack of understanding of their prognosis and outcomes of treatment. Dyads did not discuss their lung cancer experience in terms of decision-making; rather, most articulated their role as following physician guidance. Distinct lack of understanding about disease course, severity, and prognosis may constrain patient perception of the need for informed decision-making over the course of care. Dyadic interviews detailing safety-net patient experiences of lung cancer care raise important questions about how clinicians, as well as researchers, conceptualize processes of informed decision-making in vulnerable populations. Safety-net patients may not perceive their role as involving informed decision-making and further may lack understanding of disease course and individual prognosis. Safety-net patient dyads expressed high involvement in care and a desire for clarity; clinicians should be prepared to clearly communicate disease stage and prognosis.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available