Stakeholder perspectives on six identified interpersonal communication components of patient navigation in breast cancer care.

PURPOSE: Although identified as a key competency domain and a needed area of professional development, interpersonal communication in breast cancer care patient navigation is understudied. Moreover, the patient-navigator relationship may be influenced by the interpersonal communication skills and behaviors of the patient navigator. This paper reports on the interpretation step of a concept mapping study, where key stakeholders shared their perspectives on six identified interpersonal communication components of breast cancer care patient navigation. METHODS: This study utilized concept mapping, a community-engaged mixed method approach. After conducting brainstorming, sorting, and concept mapping analysis, a six-cluster concept map of interpersonal communication in breast cancer care patient navigation was identified. Interpretation sessions with each participant group (patients, patient navigators, administrators) allowed both naming and more in-depth exploration of the six clusters. The sessions were led by a facilitator, the PI, and were audio recorded and transcribed. RESULTS: Six 2-h interpretation sessions were conducted with 21 participants, including patients with breast cancer, breast cancer patient navigators (lay or medically trained), and patient navigation administrators from Western Pennsylvania. Through a group consensus process, the six clusters were named. Participants identified that all six identified components were essential to patient navigation, but the ability to build patient-centered trust and relationships and maintain professional communication were the most impactful components of the patient-navigator relationship. CONCLUSION: These findings validate the importance of interpersonal skills and behaviors of patient navigators in breast cancer care. These findings can inform the patient navigation role description, competencies, and the development of curriculum for training and metrics for evaluation.

Using Concept Mapping to Explore Interpersonal Communication Components of Patient Navigation in Breast Cancer Care.

BACKGROUND: Research exploring the relational dimensions of patient navigation identifies interpersonal communication as fundamental to the patient navigator's (PN's) ability to reduce barriers to care and improve cancer care outcomes. Although interpersonal communication is a core competency for PNs, its key components are commonly understudied and overlooked. OBJECTIVE: The purpose of this study was to identify the key interpersonal communication components of patient navigation in breast cancer care that patients, PNs, and PN administrators perceived to impact the patient-navigator relationship. METHODS: This study used concept mapping, a community-engaged research method. Participants completed 3 concept mapping activities: brainstorming, sorting and rating, and interpretation. RESULTS: A total of 31 persons participated in the study: 13 patients, 14 PNs, and 4 PN administrators. The concept mapping analysis produced a 6-cluster concept map, and each concept was named through a group consensus process. Among the 6 concepts, both patients and PNs emphasized the importance of "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: Patients, PNs, and PN administrators all emphasized the essential role of interpersonal communication in the PN-patient relationship and how it is woven into every aspect of the PN role. IMPLICATIONS FOR PRACTICE: As a core competency, we need to work toward the development and testing of evidence-based training to support their professional development and ultimately promote positive cancer care outcomes.

Power and Privilege: A Critical Analysis of Interpersonal Communication in Health Care as a Guide for Oncology Patient Navigation in Breast Cancer Care.

Despite advances in cancer care, inequalities in race, ethnicity, and social class in breast cancer outcomes still exist. Interpersonal communication is a critical piece to addressing health disparities and it is a core component of the oncology patient navigator role. While widely used, the concept of interpersonal communication is vague, understudied, and requires better clarification to promote equity in health communication. The aim of this article is to investigate the concept of interpersonal communication through a critical lens. Findings from this critical analysis identified a gap in the current literature addressing the intersections of race, gender, and social class.

Ethical tipping point: Nurses' presence on social media.

ABSTRACT: This article discusses ethical concerns surrounding social media content posted by nurses; specifically, how these posts may violate public trust. It also summarizes considerations for nurses to contemplate before posting to social media and provides examples of positive uses of social media.

Predictors of Adherence and Treatment Delays among African American Women Recommended to Receive Breast Cancer Chemotherapy.

BACKGROUND: Recognition of potential explanations for nonadherence or treatment delays is crucial to improving survival, particularly among African American women, for whom there is limited research assessing patient factors that influence adherence to breast cancer chemotherapy. OBJECTIVE: This study sought to examine the association of patient factors such as age, income, employment, and partner status with adherence (full dose/on time) to prescribed breast cancer adjuvant chemotherapy and delays in treatment among African American women. METHODS: This observational, prospective study used baseline data from the Adherence, Communication, Treatment, and Support Intervention Study that included African American women with early stage breast cancer who were recommended to receive chemotherapy. Eleven baseline demographic variables measured by a sociodemographic questionnaire were analyzed against the outcome variables of 85% adherence to chemotherapy, dichotomized as yes or no, and chemotherapy treatment delays measured as number of days. RESULTS: For the 121 African American women included in this study, only employment status and number of comorbidities were significant predictors for total treatment delays (incidence rate ratio [IRR] = 2.175 [p = .000]; IRR = 1.234 [p = .003]) in the adjusted models. IMPLICATIONS: Employment status and number of comorbidities are predictors of the ability to receive timely breast cancer chemotherapy among African American women. This knowledge allows identification of patients in need of tailored supportive care to encourage adherence and prevent treatment delays.