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From community to scale: Using community engagement to develop and validate a patient-informed cancer communication
Lauren M Hamel1, Diliara Bagautdinova1, Bill Winkler2
1Wayne State University Department of Oncology/Karmanos Cancer Institute, 4100 John R, Detroit, MI MM03CB, USA.
Objective:
Racial disparities in clinical communication quality are well-established but most clinical communication assessment tools are created without the collaboration of racially-diverse patient populations. Our objective was to collaborate with Black and White cancer survivors, caregivers, and advocates to develop and validate a tool to assess physicians' patient-centered communication.
Methods:
A panel of Black and White cancer survivors, caregivers, and advocates (n = 11) and researchers observed and discussed video-recorded patient-physician cancer clinical interactions to generate and refine a list of physician communication behaviors considered critical for high-quality patient-centered communication. Raters applied the 22-item scale (Patient-Informed Cancer Communication Scale; PICCS) assessing physicians' patient-centered communication to video-recorded interactions (n = 61) from a larger study. We determined constructs using scale development and factor analysis and validated the scale through correlation with existing scales.
Results:
Factor analysis identified five factors: treatment options; clinical relationship; prognosis and goals of treatment; explanations; and context. Treatment options, prognosis and goals of treatment, and the full scale correlated with a validated patient active participation scale. Clinical relationship and context correlated with a validated physicians' patient-centered communication scale.
Conclusion:
This community-engaged research produced a reliable and valid scale to assess physician patient-centered communication in the context of Black and White people with cancer.
Practice Implications:
With further validation work, this scale can be used to train and assess physician communication quality when discussing cancer treatment in diverse cancer patient populations.
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