Brandes, K., Linn, A. J., Smit, E. G., & Van Weert, J. C. M. (2015). Patients’ reports of barriers to expressing concerns during cancer consultations. Patient Education and Counseling, 98(3), 317-322. doi: 10.1016/j.pec.2014.11.021

Abstract:
Objective: To identify cancer patients’ most influential barriers to expressing concerns during cancer consultations in a new manner by examining patients’ reports of perceived barriers and perceived occurrence of barriers in consultations.
Methods: Two online focus groups (N = 16) and an online survey (N = 236) were conducted among cancer patients and cancer survivors. The online focus groups and survey were used to examine two elements of patients’ barriers, i.e., patients’ reports of perceived barriers and perceived occurrence of barriers in consultations. Composite scores of these two elements were calculated to determine influential barriers.
Results: Results showed that the most influential barriers were related to providers’ behavior (e.g., providers do not explicitly invite patients to express concerns) and the environment where the consultation takes place (e.g., perceived lack of time).
Conclusion: The results of this study indicate that influential barriers to expressing concerns are barriers that patients cannot overcome themselves (i.e., they are related to providers’ behavior or the environment of the consultation). A collaborative approach between researchers, providers and policy makers is needed to overcome these barriers.
Practice implications: The results of this study can be used to develop strategies to overcome barriers to patients expressing concerns.

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