Identifying the Interpersonal Communication Components of Breast Cancer Care Patient Navigation

• Main Author: Gallups, Sarah Frazier
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2018
• Subjects: Cancer; Empathy; Interpersonal communication; Nursing; Oncology; Patients
• ISBN: 0438774965; 9780438774964

Background: Patient navigation is an increasingly popular tool used in healthcare to address disparities in cancer care. Interpersonal communication is considered a critically important construct in patient navigation, although it is understudied. Moreover, the patient-navigator relationship may be influenced by the interpersonal communication skills and behaviors of the patient navigator. The primary goal of this dissertation research was to explore the perspectives of key stakeholders (patients, patient navigators and patient navigator administrators) on the interpersonal communication components of breast cancer care patient navigation and the relationship of these components to the patient-navigator relationship. Methods: This study employed concept mapping, an innovative community-engaged mixed method approach that produces pictorial views of how concepts are interrelated. Key stakeholders participated in study planning and participants completed the concept mapping activities, including brainstorming, sorting, rating, and interpretation. Brainstorming, sorting and rating were completed online. Interpretation took place through in-person sessions separated by participant group. Results: Thirty-one participants including patients with breast cancer, breast cancer patient navigators and patient navigator administrators from Western Pennsylvania participated. During brainstorming, 121 non-unique items were generated. These statements were combined into one master list of 85 items. After the sorting and rating step, the 85 items were grouped into a six-cluster concept map. Through the group consensus process during the interpretation sessions, the six clusters were named. Diagrams produced by participants noted that all the identified components were essential to patient navigation, but Skills to Build Trust and Patient Centered Relationships and Maintain Professional, Positive and Thoughtful Communication and Care were the most impactful components for promoting the patient-navigator relationship. Results of the rating step showed no notable differences between groups with participants rating Empathetic, Comprehensive and Compassionate Support, Bridge to Clinical Education and Supportive Resources, and Ongoing Individualized Coordination of Care as the most important components for facilitating the patient-navigator relationship. Conclusion: These findings have both identified and operationalized the emerging interpersonal skills and behaviors of patient navigators in breast cancer care. These identified components can inform the patient navigation role description, competencies, and the development of curriculum for training and metrics for evaluation.