Patients' reports of barriers to expressing concerns during cancer consultations

- Composite scores of perceived barriers and perceived occurrence of barriers in consultations.
- Barriers were related to providers' behavior (e.g., lack of empathy, not eliciting concerns).
- Barriers were also related to the environment of the consultation (e.g., lack of time).
- Legitimacy barriers did not seem to withhold patients from expressing concerns.
- Results can be used to develop strategies to reduce barriers to expressing concerns.

ObjectiveTo 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.MethodsTwo 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.ResultsResults 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).ConclusionThe 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 implicationsThe results of this study can be used to develop strategies to overcome barriers to patients expressing concerns.