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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Navigating Disagreements on Health Information: How Patients With Cancer Perceive Health Care Providers' Approaches
Ilona Fridman1, Cambray Smith2, Amy Barrett3
1Lineberger Comprehensive Cancer Center University of North Carolina Chapel Hill, Chapel Hill, NC.
Purpose:
Although publicly available cancer-related information online and offline could help patients make informed decisions, it also poses challenges due to prevalent misinformation. Patients need proper provider guidance to ensure they use valid and relevant information in decisions. We identify effective communication approaches for providers when (1) discussing patient-identified information and (2) disagreeing with it.
Methods:
From June to August 2023, people living with cancer were reached via online communities and asked first about their actual experiences discussing patient-identified information with their providers. Respondents were then randomly assigned into an experiment with three hypothetical scenarios where providers disagreed with patient-identified information. Provider responses included (1) dismissal, (2) explanation, and (3) explanation with relationship-building elements. Pearson correlation and multivariable analysis of variance were used to evaluate differences in patient perceptions.
Results:
One hundred seventy-five respondents completed the survey. Mean age: 53 years; 45% female; and 88% White, 10% Black, and 2% others. Forty-six percent held Bachelor's degrees or higher, 11% lived rurally, 36% reported financial difficulties, and 46% rated their health as good/excellent. Between 31% and 37% of respondents reported their provider used communication approaches that negatively correlated with discussion outcomes. The approaches included avoidance of such conversations due to limited time, discouragement of future information searches, or judgmental comments. In the experiment, respondents randomly assigned to receive relationship-building elements were significantly more comfortable sharing information, felt more satisfied, respected, and trusted their provider's opinion more than those receiving the dismissal scenario. The explanation scenario was not perceived differently compared with the dismissal scenario.
Conclusion:
More than a third of respondents reported negative communication when sharing patient-identified information with their provider. Provider prioritization of relationship-building alongside explanations could foster trust and facilitate open information exchange, supporting informed decisions.
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