High levels of socioeconomic deprivation do not inhibit patients’ communication of concerns in head and neck cancer review clinics

Abstract

To examine associations between socioeconomic status and the extent to which patients with cancer of the head and neck expressed concerns to surgeons during routine follow-up clinics, we analysed audio recordings of 110 consultations with one consultant. We used the Verona Coding Definitions of Emotional Sequences (VRCoDES) to measure communication between the doctor and the patient, and grouped the English indices of multiple deprivation (IMD) 2015 scores into deciles to compare the VRCoDES with socioeconomic status. There were no significant correlations between IMD decile and the number and type of cues and concerns, or the type of response by the consultant, but there was a positive correlation between IMD decile and duration of appointment (r = 0.288, p < 0.01). When the duration of appointment was controlled for, there was a negative correlation between IMD decile and number of cues and concerns (r = −0.221, p < 0.05). These findings question the assumption that socioeconomic status is associated with a patient’s willingness to express concerns. Shorter consultations suggest that less time is spent responding to their concerns or building a rapport. Clinicians might find it advantageous to adopt strategies that will improve their understanding of these patients and help them to communicate more effectively.