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Patterns of interactions among patients with advanced pancreatic cancer, their caregivers, and healthcare providers during symptom discussions

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Abstract

Purpose

Effective symptom discussion is an essential step to enhance symptom management in patients with advanced pancreatic cancer (APC). However, little is known about how these patients communicate their symptoms during health encounters. The purpose of this study was to develop a typology to describe patterns of interactions between patients with APC, their caregivers, and healthcare providers as regards to symptoms and symptom management.

Methods

Thematic analysis was used to analyze 37 transcripts of audio-recorded, naturally occurring encounters among APC patients, caregivers, and healthcare providers. Transcripts were drawn from the Values and Options in Cancer Care study, a larger randomized controlled communication and decision-making intervention trial, which recruited advanced cancer patients and caregivers across the USA. All transcripts from APC patients that were pre-intervention were analyzed.

Results

Eight unique types of interaction patterns among patients, caregivers, and healthcare providers were identified as follows: collaborative interactions, explanatory interactions, agentic interactions, checklist interactions, cross-purpose interactions, empathic interactions, admonishing interactions, and diverging interactions.

Conclusions

Our findings provide a systematic description of a variety of types of interaction patterns regarding symptom discussion among APC patients, caregivers, and healthcare providers. These typologies can be used to facilitate effective communication and symptom management.

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Funding

Chia-Chun Tang was supported by the Behavioral Cooperative Oncology Group (BCOG) Center for Symptom Management and Walther Cancer Foundation (2014–2016 Graduate Student Fellowship Award). The authors have full control of all primary data and agree to allow the journal to review data if requested.

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Authors and Affiliations

  1. National Taiwan University School of Nursing, No1, Sec 1, Jen-Ai Rd, Taipei, Taiwan, 10051

    Chia-Chun Tang

  2. Angela Barron McBride Endowed Professorship in Mental Health Nursing, Indiana University School of Nursing, 600 Barnhill Drive, NU409W, Indianapolis, IN, 46202, USA

    Claire Draucker

  3. University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY, 14642, USA

    Mohamedtaki A. Tejani

  4. Department of Community & Health Systems, Indiana University School of Nursing, 600 Barnhill Drive, NU 407, Indianapolis, IN, 46202, USA

    Diane Von Ah

Authors
  1. Chia-Chun Tang
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  2. Claire Draucker
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  3. Mohamedtaki A. Tejani
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  4. Diane Von Ah
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Corresponding author

Correspondence to Chia-Chun Tang.

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The authors declare that they have no conflict of interest.

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Tang, CC., Draucker, C., Tejani, M.A. et al. Patterns of interactions among patients with advanced pancreatic cancer, their caregivers, and healthcare providers during symptom discussions. Support Care Cancer 26, 3497–3506 (2018). https://doi.org/10.1007/s00520-018-4202-5

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  • DOI: https://doi.org/10.1007/s00520-018-4202-5

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