A study led by researchers at the University of North Carolina at Chapel Hill and RTI International found supporting evidence for the validity and reliability of a survey instrument developed by the team for assessing patient-centered communication in cancer care and research settings.
[Photo: Dr. Bryce Reeve]
Dr. Bryce Reeve, professor of health policy and management at UNC’s Gillings School of Global Public Health and member of the UNC Lineberger Comprehensive Cancer Center, is first author of the study, published online Feb. 10 in Patient Education and Counseling.
Patient-centered communication (PCC) is essential to the provision of high-quality, patient-centered care. Because standard measures are needed to measure, consistently and accurately, how well health professionals communicate with their patients, RTI and UNC developed a comprehensive, publicly available instrument called Patient-Centered Communication in Cancer Care (PCC-Ca).
The instrument assesses PCC in six core areas – exchanging information; making decisions; fostering healing relationships; enabling patient self-management; managing uncertainty; and responding to emotions.
To evaluate the psychometric performance of the PCC-Ca measures, the researchers surveyed 501 colorectal cancer patients, ages 21 years and older, living in North Carolina. Eighty percent of the respondents had colon cancer; 17 percent had rectal cancer; and 3 percent had multiple primary cancers. Patients were asked, within two to three months of their diagnosis, to complete an 87-question survey. Participants completed a follow-up assessment within two to three months from the baseline survey.
The study provided theory-grounded, valid and reliable PCC measures that can be used by numerous organizations – including health systems, public-sector programs and agencies, insurers, health professional organizations, medical educators, accreditation organizations and other entities invested in improving quality of care – to assess PCC comprehensively.
The study team developed a short, six-item version (PCC-Ca-6) that provides an overall PCC score and a longer, 36-item version (PCC-Ca-36) that provides scores for individual PCC core areas noted above and an overall PCC score.
Future work will evaluate the measures longitudinally and test them in other cancer populations.
“These measures address a critical need to have valid, reliable measures of the different types of communication that occur between patients and providers,” Dr. Reeve said. “We can use these tools to assess the type and extent of PCC that occur throughout the continuum of cancer care, from diagnosis through active treatment and into survivorship phases. The measures also evaluate the effectiveness of interventions to improve patient-provider communication. Improved provider-patient communication is associated with better health outcomes and satisfaction with care.”
Study co-authors from UNC include Dr. David M. Thissen, professor of psychology and neuroscience; Dr. Hanna K. Sanoff, assistant professor of hematology and oncology in the UNC School of Medicine and member of UNC Lineberger Comprehensive Cancer Center; Mr. Jason He, graduate student in psychology and neuroscience; Ms. Kathryn D. Jackson, Master of Science in Public Health candidate in health policy and management at the Gillings School; and Ms. Courtney Mann, research associate, UNC Lineberger Comprehensive Cancer Center.
Other co-authors are from RTI International, including Dr. Carla M. Bann, fellow, and Ms. Nicole Mack, statistician, both in the Division of Statistical and Data Sciences; Dr. Katherine Treiman, senior research scientist at the Center for Communication Science; Ms. Laura K. Wagner, and Ms. Rebecca Moultrie, research public health analysts in the public health research division; and Dr. Lauren McCormack, vice president of the public health research division and adjunct professor in health policy and management at the Gillings School.
Ms. Nancy Roach, founder and board chair of Fight Colorectal Cancer, and Dr. Brooke E. Magnus, assistant professor of psychology at Marquette University, are also co-authors.
Funding for the research reported in this study was provided through a Patient-Centered Outcomes Research Institute (PCORI) award.