TitleCommunication-participation behavior during the delivery of breast-cancer care
NameVenetis, Maria Koskan (author), Robinson, Jeffrey D. (chair), Greene, Kathryn L. (internal member), Yanovitzky, Itzhak (internal member), Street, Richard L. (outside member), Rutgers University, Graduate School - New Brunswick,
SubjectCommunication, Information and Library Studies,
Physician and patient,
DescriptionThis two-study dissertation examines the association between communication-participation behaviors and cancer patients’ post-visit psychosocial health outcomes. Study one was a meta-analysis of 25 articles (including 10 distinct data sets) that examined the association between patient-provider communication and patients’ post-visit satisfaction. The meta-analysis found that communication behaviors representing patient-centered care were significantly associated with patients’ post-visit satisfaction. Study two was conducted to further explore the association between communication-participation behaviors and patients’ post-visit psychosocial health outcomes. Communication-participation behaviors included: (1) surgeon partnership building; (2) surgeon supportive talk; (3) client assertive responses; (4) client question asking; and (5) client expression of concern (Street & Millay, 2001). Inductive/grounded thematic analysis (Strauss & Corbin, 1998) of these communication-participation behaviors produced six secondary communication-participation variables: (1) surgeon partnership building: question solicitation; (2) surgeon partnership building: other; (3) patient assertive responses: stating preferences; (4) patient assertive responses: challenging surgeon; (5) patient question asking: self-initiated; and (6) patient question asking: prompted. Patients’ psychosocial outcomes included: (1) illness uncertainty (Mishel, 1988); (2) mental adjustment to cancer (Watson et al., 1988); (3) patients’ satisfaction with surgeons’ visit communication; (4) patients’ satisfaction with treatment plans; and (5) patients’ intentions to adhere to treatment plans. Data were videotapes of treatment-decision-making conversations between a single surgeon and 51 of his newly diagnosed female breast-cancer patients, as well as pre- and post-visit surveys. Major findings were that communication-participation behaviors were significantly associated with decreases in patients’ uncertainty and increases in patients’ adaptive coping styles. For example, increases in surgeon partnership building were associated with decreases in patients’ unpredictability uncertainty from pre- to post visit; increases in patient assertive responses: stating preferences were associated with increases in patients’ fighting spirit and decrease in anxious preoccupation from pre- to post visit; increases in patient assertive responses: challenging surgeon were associated with decreases in patients’ fatalism from pre- to post visit. Communication-participation behaviors, and in particular patient question asking, were significantly, negatively associated with patients’ satisfaction with treatment plans and patients’ intentions to adhere to treatment plans. These findings, their implications, and directions for future research are discussed.
NoteIncludes bibliographical references
Noteby Maria Koskan Venetis
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.