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A. Smith
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P2.07 - Poster Session with Presenters Present (ID 468)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Nurses
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.07-001 - Non-Negotiated Companion Influence on Information Exchange at Lung Cancer Clinic Consultations (ID 4909)
14:30 - 14:30 | Author(s): A. Smith
- Abstract
Background:
Effective information exchange is an asset to effective cancer care (Thorne et al, 2005). Lung cancer is a disease with many biomedical, physical and psychological consequences. This underlines the need for patient-centred care, tailoring communication to the specific needs, values and information preferences of each individual (Kissane et al, 2010). In the context of patient-centred care, communication with healthcare professionals can impact the effectiveness of the clinical encounter and influence clinical outcomes for patients with cancer (Aiello et al, 2008). However, the way in which healthcare professionals exchange information with patients can be affected by wide-ranging, external factors. The presence and involvement of a companion can increase the challenge and complexity of information exchange during cancer consultations (Albrecht et al, 2010). Companions add extraordinary dynamics to the clinical interaction and their potential to influence the exchange, either in a mediating or moderating manner warrants further investigation. As patients with lung cancer are commonly accompanied to the consultation by companions and as national and international policies advocate accompaniment, research in this area is germane.
Methods:
Qualitative, multiple case study design. Each case centred on a patient with lung cancer. It included health professionals patients consulted with and any accompanying companion(s). Seven cases were recruited, including 12 companions, and six professionals. Participants were recruited in 2010-2011 at outpatient clinics. Data were: consultation recordings, debrief interviews immediately post-consultation and later in-depth patient (possibly with companion) interviews. Analysis followed case study pattern matching and coding traditions.
Results:
Each patient was accompanied by at least one companion. Three levels of negotiated companion accompaniment were identified: reciprocal/mutually agreed, partially negotiated/coerced and non-negotiated. Companions mediated and moderated information exchange across six major constructs. Mediating constructs were physical, emotional and informational, and moderating constructs were companion control, companion agenda and companion as expert. Companions with a non-negotiated presence were powerful and expert and moderated information exchange.
Conclusion:
Companion accompaniment to lung cancer clinics if often a negotiated process and one that patients may not have total autonomy over. Accompanying companions can influence the exchange of clinical information in both a mediating and moderating manner. The level of negotiated companion presence at lung cancer consultations has clinical implications that require policy, professional and patient attention. In order to facilitate the delivery of patient-centred care and communication healthcare professionals should be aware of and respect patient preference for companion accompaniment and involvement when policy initiatives often recommend companion presence during cancer consultations.
