Achieve Equity in Patient Communication With These Evidence-Based Approaches

January 10, 2023 by Elisa Becze BA, ELS, Editor

Equalizing the quality of patient-provider communication for Black versus White patients is one way to reduce the systemic racial disparities prevalent in cancer care, researchers reported in study findings ( published in the November 2022 issue of the Oncology Nursing Forum. They identified critical opportunities for oncology nurses to improve interpersonal communication with Black patients. Nurses are key drivers to affecting change and cancer outcomes for all patients, they reported.

The research team, which included ONS members and nurse scientists Timiya S. Nolan, PhD, APRN-CNP, ANP-BC, and Rachel Hirschey, PhD, RN, conducted a systematic literature review ( to assimilate the evidence for factors that affect interpersonal nurse-patient communication. A total of 24 published articles met the study’s inclusion criteria: (a) sample population with a cancer diagnosis of any kind, (b) information for Black or African American participants, and (c) information on patient-clinician communication.

Factors That Promote Positive Patient-Provider Communication

It's About Building Relationships, Not Just Communicating: All of the studies in the researchers’ literature review identified the patient-provider relationship as a key component of communication ( and many of them indicated a need for improvement.

Relationships Are Built on Mutual Trust: Trust is the foundation for positive and effective communication. The studies demonstrated ( that when Black patients with cancer trust clinicians, they are more active in conversations and seek additional information. However, several studies reported a lack of trust between clinicians and Black patients in their patient populations.

Apply That Trust to Shared Decision-Making: Multiple studies found that ( most patients rely on their clinicians to provide them with information for effective decision-making, yet Black patients consistently receive less information compared to White patients.

Don’t Underestimate the Influence of Social Determinants of Health: Low literacy levels, low economic status, cultural perceptions of cancer, and a provider’s own race or ethnicity all affected the patient-provider relationship ( in the studies included in the literature review.

Actively Approach Patient Communication With These Strategies

“For a multitude of reasons, nurses are ideally positioned to work for equitable outcomes among all patients with cancer,” the researchers said ( They advised beginning by actively addressing the patient-reported topics of concern they discovered ( during their literature review:

“As the most trusted profession, nurses can lead the way in rebuilding the healthcare system to be trustworthy,” the researchers wrote ( “These efforts will take time and dedication from nurses and should include empathetic curiosity, learning focused on the injustices patients face, engagement with communities, self-reflection, and cultural humility.”

They added that ( their findings “point to the need for a person-centered approach, which can be guided by transcultural nursing theory, highlighting the understanding and respect of a patient’s culture as foundational to meeting a patient’s needs.” They recommended that nurses consider using the Transcultural Assessment Model (, which includes assessments for:

The researchers concluded by ( calling for increased nursing advocacy and additional studies to “identify and test multilevel strategies that oncology nurses can use to promote health equity for all patients through individual, interpersonal, and systems-level change.”

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