TY - JOUR
T1 - “I Didn’t Do Into Medicine Just to be on the Phone”
T2 - Emotional Expression as Sacrosanct During Serious Illness Patient-Physician Advanced Cancer Care Communication During the COVID-19 Pandemic
AU - Kaur-Gill, Satveer
AU - Drummond, Darlene K.
AU - Zhang, Jingyi
AU - Butcher, Rebecca
AU - Eggly, Susan
AU - Schifferdecker, Karen
AU - Brooks, Gabriel A.
AU - Murray, Genevra F.
AU - Kapadia, Nirav S.
AU - Hanson, Laura C.
AU - Barnato, Amber E.
N1 - Publisher Copyright:
© 2024 Taylor & Francis Group, LLC.
PY - 2024
Y1 - 2024
N2 - Guided by communication accommodation theory, we studied 27 physician reports of patient-physician advanced cancer communication during the COVID-19 pandemic. Advanced cancer communication requires recognizing patients’ psychosocial states and collaboratively engaging patients empathetically to develop the shared understanding necessary to guide decision-making. However, physicians found their communication underaccommodated, stemming from personal protection equipment, social distancing, and telemedicine. Based on provider perspectives, our study identified that during advanced cancer communication, emotional expression was critical for reflecting care and concern to patients, and discourse management was central to showing interest and engagement to patients by their providers. The failure to convey emotional expression to patients meant rapport-building cues were missing, impeding discourse management when navigating difficult conversations about prognosis and end-of-life care. Despite efforts to adjust emotional expression and discourse management during the pandemic to address the needs of their patients, providers were dissatisfied with their communication outcomes. Physicians struggled to relay verbal and nonverbal emotional expressions effectively, supportively, and compassionately to patients when breaking bad news during advanced cancer communication, resulting in a profound source of moral and emotional distress.
AB - Guided by communication accommodation theory, we studied 27 physician reports of patient-physician advanced cancer communication during the COVID-19 pandemic. Advanced cancer communication requires recognizing patients’ psychosocial states and collaboratively engaging patients empathetically to develop the shared understanding necessary to guide decision-making. However, physicians found their communication underaccommodated, stemming from personal protection equipment, social distancing, and telemedicine. Based on provider perspectives, our study identified that during advanced cancer communication, emotional expression was critical for reflecting care and concern to patients, and discourse management was central to showing interest and engagement to patients by their providers. The failure to convey emotional expression to patients meant rapport-building cues were missing, impeding discourse management when navigating difficult conversations about prognosis and end-of-life care. Despite efforts to adjust emotional expression and discourse management during the pandemic to address the needs of their patients, providers were dissatisfied with their communication outcomes. Physicians struggled to relay verbal and nonverbal emotional expressions effectively, supportively, and compassionately to patients when breaking bad news during advanced cancer communication, resulting in a profound source of moral and emotional distress.
UR - http://www.scopus.com/inward/record.url?scp=85211588859&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85211588859&partnerID=8YFLogxK
U2 - 10.1080/10410236.2024.2438338
DO - 10.1080/10410236.2024.2438338
M3 - Article
AN - SCOPUS:85211588859
SN - 1041-0236
JO - Health Communication
JF - Health Communication
ER -