Showing posts with label Patients. Show all posts
Showing posts with label Patients. Show all posts

Wednesday, February 10, 2021

February 10, 2021 Communication and Support Chat

We were happy so many in our community could join us for our first chat of 2021. Communicating With Your Health Care Team and Asking For Support drew twenty-seven participants from the US and internationally, too. You may find the transcript here and analytics here

Here is a small sample of the responses to our topic questions. 

T1: How would you describe what constitutes good communication with your health care team?

T1 Good communication means multi-discipline coordination, collaboration, and decision making to include the patient, innovation, and caregivers.

T1: Allowing time for questions & being responsive to questions. Getting results in a timely manner.

Our @CancerHopeNet survivors often tell me that it's critical they're communicating WITH their team, not just being dictated to (intentionally or unintentionally). Respect for personalities, beliefs and cultures is critical.

T1: Feeling heard and seen. Feeling understood. Would be amazing to feel that coordination would happen between different doctors/specialists/pharmacies with burden not all on patient for care coordination

From physician perspective, overall goals are explained at a patient centered level, daily goals are discussed with nursing staff, residents have clear idea of plan, and most important the patient feels heard and at the center of it all

T1: Good communication involves not just listening but also taking nonverbal cues from patients during the conversation. It's also very important for patients to feel comfortable asking questions to their attending and go home with a clear understanding of the situation

T2a: How has communicating with your team changed during your cancer experience?

T2: It’s been less frequent. I recently transitioned to the Nurse Practitioner. Feeling a little disconnected. Grateful to be where I am though 

T2 A I learned to not be shy and speak up and ask for things and that helped my team know what I needed help with.

T2: I think at first you don't know what questions to ask. I think that is when hearing from your doctor about patient organizations and peer support might best help. Many have a "list of questions" and FAQs. Getting that info early can help guide what to ask dr. 

T2: I haven't tried any telehealth appointments yet, but I hope they are here to stay where they make sense. i.e. that insurance will keep covering... 

T2b: Has communication between you and your healthcare team been impacted by the Covid-19 pandemic?

T2bCOVID has added such a layer of complexity to good communication! Everyone is so stretched when you call it's hard to get to the right person and if someone calls back you're repeating your story over and over or clearing up misunderstandings. 

T2b. #gyncsm this hasn’t impacted me directly: but those in my life have had repeat treatment paused. Difficult to get hold of consultant but nurse team been great

T2b: I think that telemedicine now plays a bigger role in patient consultations, but where I come from it's not readily accessible to all. And now, you have to be extra observant with patients' eye expressions since that's all you can see.

T3: Have you discussed clinical trials with your provider? How was that information communicated? Did you bring up trials or did your provider?

T3 Physician recommendation is the most important factor in patients decisions to enroll onto a #clinicaltrial. If your doctor doesn't discuss this option consider asking and/or getting a second opinion.

T3: It is tough to squeeze lots of stuff into appointments and small communication outside of appointments. Clinical trials and supportive care and side effects - so much beyond treatment to ask about and plan out.

T3 @cure_magazine shared some insight into Why it is never too soon to ask about trials . https://www.curetoday.com/view/why-it-s-never-too-soon-to-consider-clinical-trials-as-a-treatment-option

T4: What would you suggest to your health care team or health care system that would improve communication? What would you suggest to patients to improve communication?

T4: to improve communication I would recommend that there is frequent communication between the gyn onc & med onc. I would recommend that doctors not be intimidated by patients who like to ask questions.

T4: I'll raise my hand and say I don't always "do my homework" and go into a medical encounter with clear goals about what I want to discuss or walk away with. I need to block some time between appts to focus.

T4. #gyncsm Get a patient advisory group / lived experience group together online and ask them how communication can be improved. #coproduction is possible even during #covid19

T4: I’d suggest asking patients what they want & need & making sure patient feedback is included in notes. Often what patient might define as an adverse event or not differs than medical team assessment. We need to record what patient’s say.

T4: @gyncsm My oncologist is often surprised I’m in groups with 100s to 1000s of other patients comparing symptoms, side effects, & treatments with people all over country & world. We are influenced by what other patients say about a drug, for ex., not just clinical studies

T4. Timely updates to patient records and a patient survey immediately after a visit. I'd also ask that teams not see innovation as the enemy of coordination.

T4: I think spacing out appointments has helped me give enough time for each patient consult so that I can still answer questions. I also tell my patients to list down things they forgot to ask and tell me on the next visit. 

T4: Also, I appreciate it when patients ask me about what they find on Google rather than acting on these info directly and possibly getting into harm's way. More and more patients are on the Internet and doctors should be prepared to handle these "external" info. 

T5: What is the best advice you have received to communicate your need for support - emotional or physical - with your health care team?

t5: That’s a tough one. I think in life, I’ve always been a fighter. And I also want to understand things. I’ve always advocated for myself and I think the best advice is to continue to always advocate for yourself. 

T5: #CervivorAmbassador Becky Wallace shared her advice in this blog post. cervivor.org/the-power-of-s… 

T5 #gyncsm That the National Health Service #NHS IS STILL OPEN during #covid19 don’t delay if you have any concerns

T6: How do you prepare for visits with your health care team?

T6 I keep a medical journal. My prep includes writing down questions, asking about meds, and general health questions if I've noted any adverse reactions.

t6: I keep a running “note” in my phone for my next appointment. I list any questions that I would like answered or any issues I’ve been having so I don’t forget to mention. #gyncsm 

T6: Keep a notebook and write down questions in between appointments so you don't forget them. Ask who is on your team and write their info. My little notebook was filled by the time I finished 9 cycles. Ask for copies of all test results. which could lead to more ?'s. #gyncsm

Questions! Questions! Lists of things I need to remember to ask.

We end out chats with TIL standing for Today I Learned. Here are just a few examples from tonight's chat. 

TIL Good communication between the patient and the healthcare team is one of the keys to effective care delivery and patient satisfaction. It's a crucial area that should be actively worked on by all stakeholders. #gyncsm

til: How doctors have been impacted by COVID & how it’s been more difficult to “read” patients & make sure they are heard. 

TIL #gyncsm made me remember how important #PeerSupport is right now

 

Christina and I look forward to seeing you at the next #gyncsm chat on Wednesday, March 10, 2021 at 8pmET when we’ll discuss “Disparities in Gyn Cancer Diagnosis and Treatment”. See you all then!

Dee 
#gyncsm Co-founder
 
 
Related Reading:
ASCO Patient Clinician Guideline 

@canceradvocacy Survivorship Toolbox-Communication
https://canceradvocacy.org/resources/cancer-survival-toolbox/communicating/

@NPAF_tweets Skilled Communications in Shared Decision Making: A Tool Kit for Health Care Providers and Advocates
https://www.npaf.org/patients-and-caregivers/skilled-communications/

Assessing communication tool @RTI_Intl for researchers physicians
Researchers have found a link between PCC and greater patient satisfaction, treatment adherence, and quality of life. https://www.rti.org/impact/patient-centered-communication-cancer-care-instrument

OC survey Reveals Need to improve patient-provider communication
Resources before during and after appointments:
https://www.ourwayforward.com/ovarian-cancer-support-and-resources/communicating-with-hcp-team

Our Way Forward Survey Results
https://www.oncnursingnews.com/view/ovarian-cancer-survey-reveals-need-to-improve-patientprovider-communication
Our Way Forward - https://www.ourwayforward.com/

Nurse / patient communication
https://www.oncnursingnews.com/view/patient-nurse-communication-is-key-in-ovarian-cancer

Doctors need to talk to each other
https://conquer-magazine.com/issues/2020/vol-6-no-6-december-2020/1441-poor-communication-affects-patients-doctors-should-talk-with-the-patient-and-each-other

Telehealth
https://conquer-magazine.com/issues/2020/vol-6-no-3-june-2020/1284-telehealth-can-help-patients-with-cancer-during-covid-19-but-does-not-replace-in-person-treatments

Wednesday, February 3, 2021

Communicating with your Health Care Team & Asking for Supportive Care

 

It's been a few years since the #gyncsm community has spoken about how to communicate effectively with your health care team. Many things have changed since then. There are more treatment options for women to consider and discuss with their gynecologic oncologists and other oncologists. More women are asking about enrollment in clinical trials. And the pandemic has caused a change in the way patients and their healthcare team talk, from face-to-face meetings to telehealth visits and phone calls. Many women need emotional support and palliative care to help alleviate side effects from treatment but are unsure how to go about requesting that help.

We hope you will join us on Wednesday, February 10, 2021 at our new time 8pm ET, 7pm CT, 5pm PT as we discuss Communicating with your Health Care Team and Asking for Supportive Care. 

Guiding our discussion will be the following Topic (T:) Questions:

T1: How would you describe what constitutes good communication with your health care team?

T2a: How has communicating with your team changed during your cancer experience?
T2b: Has communication between you and your healthcare team been impacted by the Covid-19 pandemic?

T3: Have you discussed clinical trials with your provider? How was that information communicated? Did you bring up trials or did your provider?

T4: What would you suggest to your health care team or health care system that would improve communication? What would you suggest to patients to improve communication?

T5: What is the best advice you have received to communicate your need for support - emotional or physical - with your health care team?

T6: How do you prepare for visits with your health care team?

Since most of what we will share and discuss is not limited to gynecologic cancers, feel free to invite others impacted by cancer to join us for this discussion.

 

See you on Wednesday!


Dee and Christina


Wednesday, February 7, 2018

Let's Talk - Patient / Physician Communication Feb 7, 2018


We know that communication plays an important role in the relationship patients have with their health care providers. During this month's #gyncsm chat, Let's Talk - Patient / Physician Communicationwe discussed how communication has changed over the past few years, how you describe "good communication" and we finished the chat discussing the new ASCO Patient-Clinician Communication GuidelineWe were pleased to have ASCO (@ASCO) and Timothy Gilligan (@TimGilliganMD) Cleveland Clinic, join us for this very important chat. We had 38 participants and 2.5 M impressions during the one hour chat. You may find the more analytics here and the complete transcript here.

Some sample responses to our questions appear below. Please see the transcript for more tweets.

T1: What shifts over time have you seen in communication between patients and physicians? What seems better? What seems worse?
  • Shared decision making is for the better for all! 
  • From a Docs POV, patients are more knowledgeable and engaged in their disease and how they’d like to treat it. Sometimes Dr Google can give patients misperceptions
  • I worry about impact of EMR. Is there eye contact with physicians or are they they staring at the computer screen?
  • there has been a shift away from paternalism (i.e. not telling a patient that they had cancer because it would be "upsetting") =good for openness. Flip side, demands from behind the scenes (billing, charting) can cause distraction & less attention during appointments
T2: What does "good communication" between patient and physician look like for you?
  • Good communication requires listening and the Take 5 rule. Take at least 5 minutes to listen, 5 to comprehend/consider, & 5 to respond.
  • T2: (I'm not a physician) but in my interactions with patients & families, "good communication" looks like a "normal" conversation that you might have w/ a friend: mutual info seeking+info giving+ reflecting on goals and purpose behind decisions and choices.
  • Listen, look & feel with compassion & understanding. Take your eyes off the computer screen
  • T2:@alihaider99  presents at @ASCO  study Results: Large majority of patients, 72%, preferred face-to-face interactions. Physicians who communicated face-to-face were perceived to be more compassionate, professional, and better communicators.
  • I find the listening, curiosity, empathy and a willingness to work collaboratively are key. Plus sincere interest in the person 
T3: What do you wish more doctors would do when it comes to communication? / What do you wish more patients would do when it comes to communication?
  • I know for myself that I can spend more time preparing questions and other things to get the most out of the appointment.
  • Again, from the psych perspective, I hear patients talk about wanting respect. I hear physicians talking about pressure to be infallible. 
  • Doctors: Please look me in the eye, and do not be afraid to admit you do not know the answer to my question.
  • Be honest transparent respectful and just have a conversation. It’s that easy.
  • One of our leaders challenged us to say "I don't know" more often. Wise advice
T4: What prompted @ASCO to produce the communication guideline as part of itsSupportive Care and Treatment Related Issues guidelines? What are the key points?
  • T4: Improved communication has been associated with improvements in several health outcomes, and patient-physician communication was identified as a high-priority topic by our Supportive Care Guidelines Advisory Panel
  • T4: The guideline includes recommendations for clinician training in communication skills; facilitating family involvement in care; and discussing goals of care and prognosis, treatment selection, and end-of-life care
  • T4: The guidelines also remind me how much cancer docs have to cover and how complex each area is on its own. Was good to see communication training mentioned as well.
  • Communication, while intuitive in care, is often difficult to do effectively. Most orgs should promote guidance for effectively communicating. @ASCO took the bull by the horns & its a good thing
T5: Why was it important to include family involvement as part of the Patient-Clinician Communication guideline?
  • T5: From my perspective as an oncologist, family and other loved ones are key to getting through cancer treatments.
  • T5: Most people don't make decisions in a vacuum but in the context of their relationships.
  • So important. So so important. Patients make decisions with support of caregivers, who can often provide some clarity in the chaos of diagnosis
  • Cancer care is a family affair.
  • Most patients discuss treatment with family and often rely on family to get to treatment and help manage side effects
T6: Hope and empathy are incorporated into the Patient-Clinician Communication guideline. What is it important for patients and physicians to consider when it comes to these concepts?
  • T6: For me, empathy is the beginning, middle and end of good patient connection. If empathy is present, even the hardest conversations can happen.
  • T6: Kindness and empathy can help diffuse negative emotions associated with cancer diagnosis/treatment, and may even help to improve patients’ outcomes
  • T6 If we're talking about #precisionmedicine, and let's face it, we should be; empathy and hope are vital to the communication plan, to the wholeness approach to tx
  • T6: I think that hope is trickier. In some cases, the hope is for the best quality of life, not for cure or survival. Communicating the nature of hope matters.
T7: How can both patients and physicians prepare for visits and lay the groundwork for good communication? What have you found helpful to get answers and keep everyone informed and connected between visits?
Please scroll down to find resources shared during this chat.

Patients and caregivers are invited to continue our discussion on the Smart Patients platform at https://www.smartpatients.com/partners/gyncsm

Join us next month on our regular day (second Wednesday of the month) Wednesday, March 14, 2018 at 9pm ET as we discuss Immunotherapy with guest Dr Christian Hinrichs.
Have a good month, 

Dee
#gyncsm Co-founder
RESOURCES

Friday, February 2, 2018

February 7, 2018 Chat : Let's Talk- Patient / Physician Communication


An important part of the patient-physician relationship is communication. This month we are holding our chat a week early on Wednesday, February 7, 2018 (9pm ET | 8pm CT | 6pm PT) and our February topic is Let's Talk - Patient / Physician Communication. 

Evidence shows that better communication of health care information leads to better outcomes for patients in a number of different ways. We also know that communication related to cancer has its own set of challenges. Patients have said that hearing the words, "You have cancer", impacts them in a way in which they don't hear what their physician says next. Patients are processing those words and experiencing many different emotions. Oncologists while sharing a cancer diagnosis with a patient and their family are also challenged to provide not only scientific information but support. At diagnosis, while discussing treatments, in addressing survivorship issues and end of life care, communication is a key part of the patient and clinician relationship.

Recently, ASCO (The American Society of Clinical Oncology) took on the task of developing the Patient Communication:ASCO Consensus Guideline. An expert panel was assembled to answer the question, What communication skills and tasks can clinicians use to optimize the patient-clinician relationship, patient and clinician well-being and family well-being?. We are pleased to be joined this month by Timothy Gilligan, MD (@TimGilliganMD) Co-chair of the ASCO panel and Kari Bohlke (@karibohlke), ASCO staff member to discuss the Guideline and cancer-care communications.

Below are the questions we will ask during our chat:

T1: What shifts over time have you seen in communication between patients and physicians? What seems better? What seems worse?

T2: What does "good communication" between patient and physician look like for you?

T3: What do you wish more doctors would do when it comes to communication? / What do you wish more patients would do when it comes to communication?

T4: What prompted @ASCO to produce the communication guideline as part of its Supportive Care and Treatment Related Issues guidelines? What are the key points?

T5: Why was it important to include family involvement as part of the Patient-Clinician Communication guideline?

T6: Hope and empathy are incorporated into the Patient-Clinician Communication guideline. What is it important for patients and physicians to consider when it comes to these concepts?

T7: How can both patients and physicians prepare for visits and lay the groundwork for good communication? What have you found helpful to get answers and keep everyone informed and connected between visits? 

Our recommended readings for this chat are the ASCO Guideline which can be found at:
http://ascopubs.org/doi/full/10.1200/JCO.2017.75.2311
and the American Cancer Society page The Doctor Patient Relationship:
https://www.cancer.org/treatment/understanding-your-diagnosis/talking-about-cancer/the-doctor-patient-relationship.html

We look forward to having you join us on February 7th for this very important discussion.

Dee and Christina
#gyncsm Co-founders