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Ayele R, Macchi ZA, Jordan S, Jones J, Kluger B, Maley P, Hall K, Sumrall M, Lum HD. Holding back in communications with clinicians: Patient and care partner perspectives in Parkinson's disease. PEC Innov 2024; 4:100255. [PMID: 38304553 PMCID: PMC10832496 DOI: 10.1016/j.pecinn.2024.100255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/02/2024] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Abstract
Objectives To describe how patients with Parkinson's disease (PD) and care partners choose to share or withhold information from clinicians. Methods This is a qualitative, descriptive study nested within a multisite, randomized clinical trial of outpatient palliative care compared to standard neurologic care for PD. Interviews with patients (n = 30) and care partners (n = 30) explored experiences communicating with neurology clinicians. Thematic analyses identified themes relevant to patient-care partner-clinician communication. Results There were four themes relevant to sharing and/or withholding information from clinicians: (1) Suppressing Concerns During Visits, (2) Care Partner Awareness of Patients' Communication Barriers due to Cognitive Impairment, (3) Limited Sharing of Sensitive or Intimate Issues by Patients and Care Partners, and (4) Patient and Care Partner Suggestions to Overcome 'Holding Back'. Conclusion Limitations to communication between patients, care partners, and clinicians should be acknowledged and recognized in routine Parkinson's disease care to foster accurate disclosure of unmet palliative care and other needs. Triadic communication strategies may help patients and care partners talk about unmet palliative care needs. Innovation By recognizing that cognitive impairment and sensitive topics can be barriers, clinicians can adjust or adopt targeted communication strategies for identifying and discussing care needs.
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Affiliation(s)
- Roman Ayele
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Aurora, CO 80045, United States of America
- College of Nursing, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Aurora, CO 80045, United States of America
- Denver-Seattle Center of Innovation, Rocky Mountain Regional Veterans Affairs Medical Center, 1800 N. Wheeling Street, Aurora, CO 80045, United States of America
| | - Zachary A. Macchi
- Department of Neurology, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Aurora, CO, 80045, United States of America
| | - Sarah Jordan
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Aurora, CO 80045, United States of America
| | - Jacqueline Jones
- College of Nursing, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Aurora, CO 80045, United States of America
| | - Benzi Kluger
- Departments of Neurology and Medicine, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States of America
| | - Patrick Maley
- Patient and Caregiver Advisory Council, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, United States of America
| | - Kirk Hall
- Patient and Caregiver Advisory Council, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, United States of America
| | - Malenna Sumrall
- Patient and Caregiver Advisory Council, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, United States of America
| | - Hillary D. Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave, Aurora, CO 80045, United States of America
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