"It's Not Like You Need to Live 10 or 20 Years": Challenges to Patient-Centered Care in Gynecologic Oncologist–Patient Interactions. (July 2016)

• Record Type: Journal Article
• Authors: Hsieh, Elaine; Bruscella, Jacqueline; Zanin, Alaina; Kramer, Eric M.
• Is Part Of: Qualitative health research. Volume 26:Number 9(2016)
• Page Start: 1191
• Page End: 1202
• Publication Date: 2016-07
• Subjects: discourse analysis -- patient-centered care -- provider–patient communication -- patient-centeredness -- patient perspectives -- preferences -- qualitative -- USA; Health -- Periodicals; Health behavior -- Periodicals; Health -- Research -- Methodology -- Periodicals; Health behavior -- Research -- Methodology -- Periodicals; 610.7205
• DOI: 10.1177/1049732315589095
• Languages: English
• ISSNs: 1049-7323

Abstract

The literature suggests that the patient-perspective approach (i.e., eliciting and responding to patients' perspectives, including beliefs, preferences, values, and attitudes) to patient-centered care (PCC) is not a reliable predictor of positive outcomes; however, little is known about why the patient-perspective approach does not necessarily lead to positive outcomes. By using discourse analysis to examine 44 segments of oncologist–patient interactions, we found that providers' use of patient-perspective contextualization can affect the quality of care through (a) constructing the meanings of patient conditions, (b) controlling interpreting frames for patient conditions, and (c) manipulating patient preferences through strategic information sharing. We concluded that providers' use of patient-perspective contextualization is an insufficient indicator of PCC because these discursive strategies can be used to control and manipulate patient preferences and perspectives. At times, providers' patient-perspective contextualization can silence patients' voice and appear discriminatory.