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Qualitative Health Research
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Patient Real-Time and 12-Month Retrospective Perceptions of Difficult Communications in the Cancer Diagnostic Period

Sally Thorne

University of British Columbia,Vancouver, British Columbia, Canada, sally.thorne{at}nursing.ubc.ca

Elizabeth-Anne Armstrong

University of British Columbia,Vancouver, British Columbia, Canada

Susan R. Harris

University of British Columbia,Vancouver, British Columbia, Canada

T. Gregory Hislop

British Columbia Cancer Research Centre,Vancouver, British Columbia, Canada

Charmaine Kim-Sing

British Columbia Cancer Agency,Vancouver, British Columbia, Canada

Valerie Oglov

University of British Columbia,Vancouver, British Columbia, Canada

John L. Oliffe

University of British Columbia,Vancouver, British Columbia, Canada

Kelli I. Stajduhar

University of Victoria,Victoria, British Columbia, Canada

Communication is a notoriously complex challenge in the cancer care context. Our program of research involves exploration of patient—provider communications across the cancer trajectory from the patient perspective.Toward this end, we have been following a cohort of 60 cancer patients, representing a range of tumor sites, from immediately after diagnosis through to recovery, chronic, or advanced disease. Drawing on interpretive description analytic techniques, we documented patterns and themes related to various components of the cancer journey. In this article, we report on findings pertaining to poor communication during the initial diagnostic period, as described by patients at the time of diagnosis and 1 year later.These findings illuminate the dynamics of communication problems during that complex period, and depict the mechanisms by which patients sought to confront these challenges to optimize their cancer care experience. On the basis of these findings, considered in the context of the body of available evidence, suggestions are proposed as to appropriate directions for system-level solutions to the complex communication challenges within cancer care.

Key Words: cancer • communication • health care • psychosocial issues • quality of life • relationships

Qualitative Health Research, Vol. 19, No. 10, 1383-1394 (2009)
DOI: 10.1177/1049732309348382
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