The caregiver clinical communication process model: advancing the model to support spousal cancer caregivers

Spousal caregivers can be critical to cancer care. They need support in building communication skills central to their role. We previously developed a Caregiver Clinical Communication Process Model (C³PM) outlining communication strategies spousal cancer caregivers use before, during, after, and in between medical visits to attain caregiving goals. We sought evidence to support the C³PM and better understand spousal caregivers' potential communication skill development needs.

We developed a 12-item scale capturing C³PM communication strategies and surveyed spousal caregivers of a person living with a blood cancer. Caregivers reported which strategies they use and perceived importance of and difficulty enacting each strategy. Responses were compared to validated measures. Mean differences between caregivers who enacted strategies versus those who did not were analyzed using independent-samples t-tests.

Participants (n = 143) confirmed using each strategy identified in the model, and rated strategies as having moderate-to-high importance. They identified discussing questions with their spouse before appointments as one of the most difficult strategies. Communicating with insurance carriers or healthcare billing personnel to address financial coverage of care was reported as most challenging.

This evidence supports the utility of the model and importance of these caregiver strategies in navigating clinical communication. The model highlights the importance of understanding caregivers' clinical communication as a multi-phase process and can be used to teach caregivers key communication skills they can enact before, during, after, and in between medical encounters to increase their cancer caregiving ability.