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The patient–provider discordance in patients’ needs assessment: a qualitative study in breast cancer patients receiving oral chemotherapy
Author(s) -
Wei Chunlan,
Nengliang Yao,
Yan Wang,
Qiong Fang,
Yuan Changrong
Publication year - 2017
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13374
Subject(s) - medicine , concordance , qualitative research , breast cancer , psychological intervention , family medicine , needs assessment , nursing , health care , social support , information needs , cancer , psychology , social science , sociology , economics , psychotherapist , economic growth , world wide web , computer science
Aims and objectives To explore the differing perspectives of patients and providers and their assessment of supportive care needs in breast cancer patients receiving oral chemotherapy. Background The patient–provider concordance in patients’ needs assessment is critical to the effective management of cancer. Self‐administered oral chemotherapy greatly shifts responsibilities for side‐effect monitoring, symptom management and dose adjustments from the provider to the patient. Home‐based care plans will be central to the effective management of these patients. Design A descriptive qualitative design was used. Methods A purposive sample of nine breast cancer patients, four oncologists and four oncology nurses were recruited in Shanghai, China. Semi‐structured and in‐depth interviews were conducted to collect data. A qualitative content analysis aimed at finding manifest and latent meanings of data was applied to analyse the information. Results Four themes of needs emerged from the interviews with patients and providers: information/knowledge, communication, social support and symptom management, but patients and providers only agreed on the assessment of symptom and side‐effects management needs. Patients want more positive encouraging information from providers, but providers think patients need more information of efficacy and safety. Patients appreciate support from other peer patients with similar experiences, but providers think the support from families and friends are readily available to them. Patients discussed their spiritual needs, while oncologists see the need to improve patient adherence to medication. Conclusion Breast cancer patients differed from their providers in assessment of healthcare needs. Further investigation of the relationships between patient–provider discordance and patient outcomes may guide interventions to improve care for cancer patients receiving oral chemotherapy. Relevance to clinical practice Oncology nurses should develop a holistic home‐based care plan by exploring and integrating the discordance of needs assessment of both patients and health providers.