The role of patient-physician relationship on health-related quality of life and pain in cancer patients

Samuel, Cleo A.; Mbah, Olive; Schaal, Jennifer; Eng, Eugenia; Black, Kristin Z.; Baker, Stephanie; Ellis, Katrina; Guerrab, Fatima; Jordan, Lauren C.; Lightfoot, Alexandra F.; Robertson, Linda; Yongue, Christina; Cykert, Samuel

doi:10.1007/s00520-019-05070-y

Cited by 31 publications

(33 citation statements)

References 42 publications

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“…Isolation, especially while facing a difficult prognosis, only amplifies the pain a patient feels and can put significant strain on their relationships outside of the hospital. Studies found that patients who experience more challenges in interpersonal communication reported lower physical and mental health-related quality of life [ 9 ]. The patient was isolated while undergoing very difficult counseling about her high-risk pregnancy and coping with the news that her fetus had a minimal chance of survival.…”

Section: Discussionmentioning

confidence: 99%

“…From a nursing perspective, subtle clinical changes in a patient's care are more likely to be evaluated efficiently when a nurse has developed a rapport and an understanding of the patient's clinical baseline by being at their bedside. Clinical evidence has demonstrated that effective patient-provider communication allows for a trusting relationship that reduces the risk of adverse events [ 9 ]. Without regular contact with patients, providers are less likely to pick up on these subtle signs, leading to a delay in response to obstetric emergencies.…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 Barriers to Care for Pregnant Patients in Prolonged Isolation

Burgoyne

Elsamadicy

Cojocaru

et al. 2020

Case Reports in Obstetrics and Gynecology

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for coronavirus disease 2019 (COVID-19), continues to have a devastating impact on healthcare systems worldwide, and many questions remain unanswered. The effect of COVID-19 on the pregnant population is widely debated, and the unique risks in pregnancy have not yet been elucidated. What has been established, however, is the recommendation for healthcare workers to use personal protective equipment (PPE) for both contact and airborne precautions to prevent transmission of the pathogen—adding another barrier to care for vulnerable populations. We report a case of a young woman from Haiti during her first pregnancy, who was admitted to the antepartum service at 22 weeks of gestation with preterm premature rupture of membranes (PPROM) and remained admitted in isolation, though asymptomatic, for over six weeks due to persistent positive SARS-CoV-2 testing. Our case highlights the unique barriers to care that COVID-19 poses to antepartum patients, particularly in the setting of pregnant women with persistent positive testing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

COVID-19 Barriers to Care for Pregnant Patients in Prolonged Isolation

Burgoyne

Elsamadicy

Cojocaru

et al. 2020

Case Reports in Obstetrics and Gynecology

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“…25 Greater provider-patient rapport is consistently linked with improved treatment adherence, retention, and health outcomes, 25-28 including HRQoL. 29,30…”

Section: Incorporating Quality Of Life Into Treatmentmentioning

confidence: 99%

Quality of Life: The Primary Goal of Lifestyle Intervention

Daundasekara

Arlinghaus

Johnston

2020

American Journal of Lifestyle Medicine

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In much of lifestyle medicine, health-related quality of life (HRQoL) is a primary focus with the assumption that symptom reduction increases quality of life (QoL) in a more global sense. Lifestyle medicine research has shown that reducing symptoms increases the likelihood that QoL is improved. However, little information is available as to the impact of interventions when they are not effective in creating the desired healthy outcomes. It is possible that some lifestyle interventions have a negative impact on QoL, especially when a patient is not “successful” in reducing their symptomatology. Considering QoL from a broader perspective as an outcome in combination with traditional health outcomes may improve provider-patient rapport and empower patients to provide feedback on treatment, which, in turn, may improve overall treatment.

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“…The existing literature has shown many different approaches used-by both patients and healthcare providers-in medical choice situations [16][17][18][19][20]. Additionally, the overall process of decision making in pain management is complex, and input may be derived from multiple factors: the clinician's assessment skills, prescribing knowledge, attitudes, communications skills and their relationship with the patient, including the degree to which shared decision-making occurs [21][22][23]; and the patient's beliefs and attitudes, their capacity to selfmanage medications and their socioeconomic characteristics such as education and racial identity [23][24][25]. Many patient concerns may impact decision making in cancer pain management and pose as attitudinal barriers to optimal opioid use: fear of addiction; fatalism-based on the association of opioids with end of life and fear of death; side-effects; opioid tolerance; concern that focussing on pain will distract from disease treatment or not allow monitoring of disease progression; desire to be a good patient; and concerns regarding compromised immunity [26,27].…”

Section: Introductionmentioning

confidence: 99%

“No thanks, I don’t want to see snakes again”: a qualitative study of pain management versus preservation of cognition in palliative care patients

et al. 2020

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Background Towards the end of life, use of opioid analgesics becomes more common in patients to control pain and improve quality of life. While pain medication may help manage pain, unwanted cognitive side effects are frequently noted. This balancing act presents a trade-off for patients between pain relief and adverse effects, where the desire to relieve pain must be evaluated against the desire to maintain cognitive clarity and may represent a difficult decision for patients receiving palliative care. Our goal was to understand how patients’ decision making about pain medications balances the pain relief from those medications against the cognitive decline often associated with them. Methods We conducted qualitative semi-structured interviews with patients receiving home-based palliative care from a program in Toronto, Canada. Interview recordings were transcribed and analyzed using thematic analysis. Results Thirty-one interviews were conducted. Some patients preferred cognitive preservation over pain management because of a sense that cognition is central to their identity, the desire to maintain lucidity, a desire to continue participating in work or hobbies, and fear of addiction. Conversely, some patients preferred pain management over cognitive preservation because of a desire to avoid suffering, an inability to sleep without medications, or an acceptance of some cognitive compromise. A few patients attempted to find balance through tapering drugs, limiting their use of breakthrough analgesic doses, or using alternative strategies. Conclusions Decision making around pain and pain management is a highly preference-sensitive process—with no clear right or wrong decisions, only the preferences of each patient. The findings from this study may influence the design of future patient-facing decision aids around pain management. Future studies should pilot interventions to better assist patients with this decision.

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The role of patient-physician relationship on health-related quality of life and pain in cancer patients

Cited by 31 publications

References 42 publications

COVID-19 Barriers to Care for Pregnant Patients in Prolonged Isolation

COVID-19 Barriers to Care for Pregnant Patients in Prolonged Isolation

Quality of Life: The Primary Goal of Lifestyle Intervention

“No thanks, I don’t want to see snakes again”: a qualitative study of pain management versus preservation of cognition in palliative care patients

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