Communication with Advanced Cancer Patients: Hospital Social Workers’ Experiences and Observations

Abstract

The purpose of this study was to understand hospital social workers’ stories of supporting patients with advanced cancer. I used a narrative approach and interviewed three hospital social workers employed with Hamilton Health Sciences about their experiences of speaking with patients about their needs, concerns, hopes, and fears. The interviews also explored social workers’ involvement in, and observations of, other professionals’ conversations with patients about diagnosis, prognosis, treatment, and palliative care. Each interview raised a unique aspect of communication with patients with advanced cancer. In my analysis, I explore the ‘mode’ of communication each social worker highlighted: sitting (which included being present and spending time), being direct and diplomatic, and preparing patients. In the discussion section, I look across all three interviews and consider how the need for psychosocial support and the institutional context played a role in their communication. For future research, it would be beneficial to have multiple points of contact with the participants, extend this work beyond the hospital, and explore the identities of the participants to achieve a deeper understanding of the range and essence of communicating with advanced cancer patients.