Communication, Decision Making, and Cancer: What African Americans Want Physicians to Know

PURPOSE: To explore and identify communication and decision making with health care providers for African Americans living with cancer and for their families. METHODS: We used focus group interviews to identify and explore cultural perceptions, expectations, and desires as they relate to quality of life domains. PARTICIPANTS: Of the 42 African American participants, 33 were women. Half of the participants (n = 21) were caregivers of a family member with cancer; the others were cancer survivors and some of them had also cared for a loved one with cancer. RESULTS: Participants focused on effective communication and decision making as fundamental to overall quality of life. Furthermore, physicians were viewed as having the responsibility to establish and monitor effective communication with patients and families. Within the domain of effective communication, participants stressed that health care providers needed to know the person and family and to tailor communication with them based on that knowledge. Within the domain of decision making, participants emphasized having a sense of control over treatment choices. They also expressed concerns for populations made vulnerable by advanced age, poverty, or low levels of formal education. DISCUSSION: Our participants indicated that relationship-centered care, in which one's sense of personhood is sought, acknowledged, and worked with, is foundational for effective communication and decision making.