Communication Considerations for Remote Contact with Cancer Patients During the COVID-19 Pandemic: Potential Harmful Situations

Background: Communication is important, especially in cancer care. Good communication can positively influence patient outcomes, whereas poor communication can cause harm. Due to COVID- 19 physical contact decreased leading to remote communication. In addition, general health care was downscaled, resulting in patients potentially receiving limited information about (treatment) changes. Currently, we do not know whether these changes are considered harmful and whether that depends on certain characteristics. Objective: This study aims to determine to which extent communication themes and communication situations within these two themes, are deemed harmful and by whom during the COVID-19 pandemic. Specifically, the relationship between patients’ age, gender, education and information need, and the changed communication (remote consultations and limited information about (treatment) changes) and specific communication situations. Methods: An online survey study was conducted based on a...Show moreBackground: Communication is important, especially in cancer care. Good communication can positively influence patient outcomes, whereas poor communication can cause harm. Due to COVID- 19 physical contact decreased leading to remote communication. In addition, general health care was downscaled, resulting in patients potentially receiving limited information about (treatment) changes. Currently, we do not know whether these changes are considered harmful and whether that depends on certain characteristics. Objective: This study aims to determine to which extent communication themes and communication situations within these two themes, are deemed harmful and by whom during the COVID-19 pandemic. Specifically, the relationship between patients’ age, gender, education and information need, and the changed communication (remote consultations and limited information about (treatment) changes) and specific communication situations. Methods: An online survey study was conducted based on a scoping review and input from researchers, clinicians, and patient representatives. Participants were eligible if they were 18 years or older, had advanced (incurable) cancer and had sufficient command of the Dutch language. Participants were presented with six potentially harmful communication situations (grouped under the themes remote consultations and limited information about (treatment) changes) which they assessed as harmful or not (yes/no). The background characteristics were dichotomised, and the relationships were measured using (logistic) regression analyses. Results: The sample existed of 47 participants, aged between 44-81. Most participants (57%–87%) perceived the communication situations as harmful. The relationships between age, gender, education, and information need and remote consultations, limited information about (treatment) changes and specific communication situations were all non-significant (p > .01). The relationship between education and not checking if the discussed information is remembered was marginally significant, c2(1, N = 46) = 6.21, p = .013 and recorded an odds ratio of 7.29 (95% CI: 1.31 – 40.54). Conclusions: As we suspect telehealth to increase, we suggest creating specific guidelines for remote contact using harmful communication examples and helpful alternatives. Furthermore, we advise physicians to provide explanations about treatment changes and as to why patients are not (or less) involved in decision-making when information provision is limited. Larger and more representative research is needed to replicate and substantiate our findings.Show less

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Communication Considerations for Remote Contact with Cancer Patients During the COVID-19 Pandemic: Potential Harmful Situations