Published: 8 April 2016

Becoming an Expert: Sarah Allen on differences in doctor-patient communication

Sarah Allen

PhD student, Sarah Allen, is exploring socioeconomic differences in doctor-patient communication with head and neck cancer patients to understand whether these differences can be reduced using the Patient Concerns Inventory (PCI).

“Before starting my PhD I gained a Masters in Health Psychology at the University of Hull while volunteering at a hospice in my home town. Through this experience I gained an interest in cancer care and the experiences of cancer patients.  Although my PhD is in Health Services Research, it still has a strong focus on Health Psychology.

“The National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast (NIHR CLAHRC NWC) funds my PhD in Health Services Research. The title of my project is ‘Influence of the Patient Concerns Inventory in the communication of head and neck cancer patients with healthcare professionals, across the socioeconomic gradient’.

“Head and neck cancer patients may experience a number of concerns following treatment such as fear of recurrence, disfigurement, and issues with feeding and speech. These may be a result of the cancer itself or the treatment.  If a patient informs their Consultant of any concerns they are experiencing during follow-up consultations, then they may be able to address these and potentially improve quality of life for the patient.

Fewer questions

“Previous research has found that people of low socioeconomic status (SES) not only are more likely to develop head and neck cancer, but they subsequently suffer worse quality of life following treatment.

“One possible explanation for this is that doctor-patient communication differs by patient SES: for example low SES patients ask fewer questions, volunteer less unprompted information, and express their opinion less often in clinical appointments, plus healthcare providers also give less time to low SES patient’s questions and provide less information anyway. Therefore low SES head and neck cancer patients may be less likely to express their concerns, which may lead to worse quality of life following treatment.

The Patient Concerns Inventory (PCI) may be a useful tool to improve doctor-patient communication. It is a 56-item question prompt list which allows the patient to select any issues which they wish to discuss in their consultation, including physical, treatment-related, social-care and psychological concerns. This is completed prior to the consultation and given to the healthcare provider, which thus facilitates the consultation being focused around patient’s needs.

Data analysis

“My research project aims to explore if and how doctor-patient communication differs by SES in head and neck cancer review consultations, and whether the PCI might influence doctor-patient communication; potentially reducing socioeconomic differences in communication between healthcare-providers and patients. I will explore this using a mixture of qualitative, such as interviews with patients, and quantitative – using coding of the doctor-patient conversation in clinic appointments methods for example.

“I am only in my first year of study, but have already had the opportunity to attend a conference in Cambridge where I presented a poster of a paper which I have written with one of my supervisors. This paper will be the first study I have published thanks to the support of my supervisors.  I will also have the opportunity to attend a number of workshops in which I will learn the skills required to conduct interviews and analyse the data.”

 

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