Nurses Play Pivotal Role in Improving Patient-Physician Communication

Saturday, August 25, 2018
Patients who report higher satisfaction with their physicians’ communication with them also were more likely to receive more efficient care with fewer office visits and better health outcomes at lower costs, according to a study published in the Journal of the National Comprehensive Cancer Network.

Because nurses are on the frontline of communication with patients, they too may help improve satisfaction.

“Nurses have a pivotal role in coordinating communication. They are the most frequent point of contact with patients and their families, and they simultaneously interface with the key components of health care teams,” Ashish Rai, PhD, from the Surveillance and Health Services Research Program in the Department of Intramural Research at the American Cancer Society, said in an interview with Oncology Nursing News.

“So, they are uniquely placed to assess the communication needs of the patient at different phases of their care, and coordinate the flow of information consistent with those needs,” he added.

Rai and colleagues at the American Cancer Society analyzed the Longitudinal Medical Expenditure Panel Survey data from 2008 to 2014 to identify factors associated with cancer survivors’ satisfaction with health care provider communication.

Patients used a 4-point scale—ranging from “never” to “always” to track whether their providers listened carefully, explained things in a way that was easy to understand, showed respect for what the respondent had to say and spent enough time with the respondent.

In addition, they evaluated the associations between different levels of satisfaction and short-term outcomes, including health status, health care utilization and expenditures including medication and out-of-pocket costs.

The researchers identified 4588 respondents diagnosed with cancer from the survey data—of which 2257 were nonelderly (aged 18 to 64 years; average age, 54 years) and 2331 were elderly patients (aged 65 years or older; average age, 75).

In both groups, higher satisfaction was associated with fewer comorbidities, suggesting that more complex circumstances negatively impacted patients’ perception of their communication, Rai said.

“Many clinically complex survivors may not have sufficient understanding of their condition, or they may feel overwhelmed by the barrage of information coming from various sources, and it may also be challenging for the providers to convey a great volume of information to these complex cancer survivors given the time constraints of the interaction,” he added.

Higher satisfaction was associated also with fewer office visits in the first year after diagnosis and absence of emergency department visits in that same year.

Elderly respondents who reported higher satisfaction in year 1 were also more likely to have better year 2 mental health and general health. In addition, greater satisfaction was associated with fewer year 2 office visits among the nonelderly, and lower year 2 healthcare expenditures among the elderly.

To conclude, the researchers noted that these results emphasized the need for individualized communication strategies for patients with cancer and survivors shaped by their distinct requirements.

“This is particularly true in cancer survivorship care which is often complex and multidisciplinary, and nurses can help to keep everyone on the same page,” Rai added.

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