From community to scale: Using community engagement to develop and validate a patient-informed cancer communication scale.

Abstract

Racial disparities in clinical communication quality are well-established but most clinical communication assessment tools are created without the collaboration of racially-diverse patient populations. Our objective was to collaborate with Black and White cancer survivors, caregivers, and advocates to develop and validate a tool to assess physicians' patient-centered communication. A panel of Black and White cancer survivors, caregivers, and advocates (n = 11) and researchers observed and discussed video-recorded patient-physician cancer clinical interactions to generate and refine a list of physician communication behaviors considered critical for high-quality patient-centered communication. Raters applied the 22-item scale (Patient-Informed Cancer Communication Scale; PICCS) assessing physicians' patient-centered communication to video-recorded interactions (n = 61) from a larger study. We determined constructs using scale development and factor analysis and validated the scale through correlation with existing scales. Factor analysis identified five factors: treatment options; clinical relationship; prognosis and goals of treatment; explanations; and context. Treatment options, prognosis and goals of treatment, and the full scale correlated with a validated patient active participation scale. Clinical relationship and context correlated with a validated physicians' patient-centered communication scale. This community-engaged research produced a reliable and valid scale to assess physician patient-centered communication in the context of Black and White people with cancer. With further validation work, this scale can be used to train and assess physician communication quality when discussing cancer treatment in diverse cancer patient populations.