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Title: A critical ethnography of communication processes involving the management of oral chemotherapeutic agents by patients with a primary diagnosis of colorectal cancer
Author: Mitchell, Gary
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2017
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Communication about medications can be one-sided, leaving the patient to take a passive role in discussions about medications. In relation to oral chemotherapy, there is a paucity of research in this area, which is surprising given the extremely narrow therapeutic index of oral chemotherapy and subsequent high risk of toxicity. The aim of this ethnographic study was to illuminate the processes of communication between healthcare professionals, patients and informal carers during oral cancer drug therapy in order to identify factors that promote or inhibit concordance and appropriate medication administration. Observations were conducted on interactions between healthcare professionals and eight patients. These observations occurred over a period of six months, in outpatient departments where prescriptions were explained and supplied, and on follow-up consultations where treatment regimens were monitored and assessed. Semi-structured interviews were conducted with patients and their informal carers during and after their six-month treatment. Focus-groups were carried out with healthcare professionals at the conclusion of the study. These data were analysed using thematic analysis. The results of this study are divided into two sections. The first relates to the patient journey to their first consultation appointment, which includes two broad themes of the shock of the lifeworld and the waiting room experience. The second explores the patient’s six-month journey of receiving communication about oral chemotherapy and this includes the three broad themes of colonization of the lifeworld, mutual system lifeworld and detachment of the system. Communication processes within oncology are complex. This study found that the main communication priority for patients, their family members and healthcare professionals, was medical management of side-effects. Importantly, communication about oral chemotherapy is not an isolated event. It occurs over a long period, is preceded by important communication processes through the diagnosis period and succeeded by supportive communication in the period after treatment.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available