Barriers Against Psychosocial Communication: Oncologists' Perceptions

1. Hanna Fagerlind⇑,
2. Åsa Kettis,
3. Bengt Glimelius and
4. Lena Ring

© 2013 by American Society of Clinical Oncology+

1. All authors: Uppsala University; Lena Ring, Medical Products Agency, Uppsala; Bengt Glimelius, Karolinska Institutet, Stockholm, Sweden.

1. Corresponding author: Hanna Fagerlind, PhD, Uppsala University, Department of Pharmacy, BMC, Box 580, 751 23 Uppsala, Sweden; e-mail: Hanna.Fagerlind@farmaci.uu.se.

1. Presented at the 19th Annual Conference of the International Society of Quality of Life Research, Budapest, Hungary, October 24-27, 2012 (poster presentation).

Abstract

Purpose To explore oncologists' psychosocial attitudes and beliefs and their perceptions regarding barriers against psychosocial communication. 

Methods A questionnaire was distributed to oncologists in Sweden (n = 537). Questions covered demography, the Physician Psychosocial Beliefs Scale (PPBS), and barriers against psychosocial communication. Stepwise multiple regression was used to determine what factors contribute the most to the PPBS score and the total number of barriers and barriers affecting clinical practice, respectively. Spearman rank-order correlation was used to determine correlation between PPBS score and number of barriers. 

Results Questionnaire response rate was 64%. Mean PPBS value was 85.5 (range, 49 to 123; SD, 13.0). Most oncologists (93%) perceived one or more barriers in communicating psychosocial aspects with patients. On average, five different communication barriers were perceived, of which most were perceived to affect clinical practice. These barriers included insufficient consultation time, lack of resources for taking care of problems discovered, and lack of methods to evaluate patients' psychosocial health in clinical practice. There was a positive correlation (r_s = 0.490; P < .001) between the PPBS score and the number of perceived barriers (ie, less psychosocially oriented oncologists perceived more barriers). Oncologists with supplementary education with a psychosocial focus perceived fewer barriers/barriers affecting clinical practice (P < .001 and P = .001, respectively) and were more psychosocially oriented (P = .001). 

Conclusion 

Oncologists perceive many different barriers affecting psychosocial communication in clinical practice. Interventions aiming to improve psychosocial communication must therefore be multifaceted and individualized to clinics and individual oncologists. It is important to minimize barriers to facilitate optimal care and treatment of patients with cancer.