What You Left out Concerns Me: A Mixed-Method, Exploratory Study Examining the Roles of Omission and Commission in Dissatisfaction Amongst Cancer Patients

Theoretical Background and research questions/hypothesis:  Patient centered communication is centered on six core communication functions: fostering healing relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient self-management (Epstein & Street, 2007). Clinician omissions and commissions contribute to patient dissatisfaction and feelings of uncertainty.

Methods:  A patient satisfaction survey, comprised of open and closed-ended questions, was developed and offered to a purposive sample of patients. A coding schematic, based on the core communication functions was developed. Open-ended responses were coded, and inter-coder reliability established. Statistical analysis was employed to explore correlations between patients' cancer type and overall satisfaction.

Results:  Preliminary results (N=367) suggest possible communication pitfalls. Initial analysis highlights differences between patient communication experiences with clinicians, and patient communication experiences beyond the clinical encounter, while navigating administrative system components. Analysis also suggests differences in the patient satisfaction level by patient cancer type.

Conclusions:  Ineffective communication, by clinicians or system administrators, has the potential to negatively impact patient satisfaction and compliance. Accordingly, successful treatment and subsequent survivorship is best facilitated by clear, effectual, patient-centered communication strategies. 

Implications for research and/or practice:  The exploration of patient satisfaction in relation to their communication experience allows for improved strategies and systems strengthening.