Commentary: Communicating in crisis: Reflections, opportunities, and challenges for healthcare communication in the COVID-19 pandemic

Authors

  • David Matthew Edmonds The University of Hong Kong, Hong Kong
  • Olga Zayts-Spence The University of Hong Kong, Hong Kong
  • Katharine Alder London North West University Health Care NHS Trust, UK

DOI:

https://doi.org/10.7146/qhc.v1i2.128540

Keywords:

Communication problems, communication training, COVID-19, doctor-patient interaction

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has changed how healthcare professionals, patients, and relatives communicate with each other. Aim: We take stock of the current state of affairs in healthcare communication research amid the continuing pandemic. We draw upon our expertise as communication researchers and clinical experience as a medical professional working in the pandemic to reflect upon the challenges and opportunities that the pandemic has created for healthcare communication research and practice. Findings: We explore five topics of importance for research on healthcare communication during COVID-19 and its aftermath. First, we discuss how the ‘epistemics’ of COVID-19 are navigated in patients’ communication with doctors. Second, we elaborate on the problems in communicating the prognostic uncertainty of COVID-19. Third, we consider online COVID-19 support groups as an important site for investigating the pandemic’s multi-dimensional impacts. Fourth, we consider the challenges of the shift from face-to-face to video-mediated healthcare service provision. Fifth, we explore how fast-tracking graduate medical students into the workforce left them feeling unprepared for the communicative demands of such work. Conclusion: We call for direct collaboration between medical professionals and healthcare communication researchers to utilize evidence-based findings to solve the communicative demands posed by the pandemic. Collaboration and research need to be adaptive to the dynamic nature of the pandemic.

References

Ahmed, W., Vidal-Alaball, J., Downing, J., & López Seguí, F. (2020). COVID-19 and the 5G conspiracy theory: Social network analysis of Twitter data. Journal of Medical Internet Research, 22(5). https://doi.org/10.2196/19458

Atalan, A. (2020). Is the lockdown important to prevent the COVID-19 pandemic? Effects on psychology, environment and economy-perspective. Annals of Medicine and Surgery, 56, 38–42. https://doi.org/10.1016/j.amsu.2020.06.010

Baraniuk, C. (2021). Where are we with drug treatments for covid-19? BMJ, 373. https://doi.org/10.1136/bmj.n1109

Berlinger, J. (2021, February 5). How a 30,000-member Facebook group is helping Hong Kong navigate one of the world’s longest quarantines. https://www.cnn.com/travel/article/hong-kong-quarantine-facebook-group-intl-hnk-dst/index.html

Bonotti, M., & Zech, S. T. (2021). Recovering civility during COVID-19. Palgrave Macmillan.

Bridgman, A., Merkley, E., Loewen, P. J., Owen, T., Ruths, D., Teichmann, L., & Zhilin, O. (2020). The causes and consequences of COVID-19 misperceptions: Understanding the role of news and social media. Harvard Kennedy School Misinformation Review, 1(3). https://doi.org/10.37016/mr-2020-028

Bumb, M., Keefe, J., Miller, L., & Overcash, J. (2017). Breaking bad news: An evidence-based review of communication models for oncology nurses. Clinical Journal of Oncology Nursing, 21(5), 573–580. https://doi.org/10.1188/17.CJON.573-580

Chau, J. P. C., Lo, S. H. S., Saran, R., Leung, C. H. Y., Lam, S. K. Y., & Thompson, D. R. (2021). Nurses’ experiences of caring for people with COVID-19 in Hong Kong: A qualitative enquiry. BMJ Open, 11(8). https://doi.org/10.1136/bmjopen-2021-052683

Cheng, H. W. B. (2021). Palliative care for cancer patients with severe COVID-19: The challenge of uncertainty. Supportive Care in Cancer, 29(3), 1153–1155. https://doi.org/10.1007/s00520-020-05809-y

Chivers, B. R., Garad, R. M., Boyle, J. A., Skouteris, H., Teede, H. J., & Harrison, C. L. (2020). Perinatal distress during COVID-19: Thematic analysis of an online parenting forum. Journal of Medical Internet Research, 22(9). https://doi.org/10.2196/22002

Chou, W. S., Hamel, L. M., Thai, C. L., Debono, D., Chapman, R. A., Albrecht, T. L., Penner, L. A., & Eggly, S. (2017). Discussing prognosis and treatment goals with patients with advanced cancer: A qualitative analysis of oncologists’ language. Health Expectations, 20(5), 1073–1080. https://doi.org/10.1111/hex.12549

Cohen, J., & Rodgers, Y. (2020). Contributing factors to personal protective equipment shortages during the COVID-19 pandemic. Preventive Medicine, 141. https://doi.org/10.1016/j.ypmed.2020.106263

Cottrell, M., Burns, C. L., Jones, A., Rahmann, A., Young, A., Sam, S., Cruickshank, M., & Pateman, K. (2021). Sustaining allied health telehealth services beyond the rapid response to COVID-19: Learning from patient and staff experiences at a large quaternary hospital. Journal of Telemedicine and Telecare, 27(10), 615–624. https://doi.org/10.1177/1357633X211041517

Crawford, P., & Orion Crawford, J. (2021). Cabin fever: Surviving lockdown in the coronavirus pandemic. Emerald Publishing.

Danielis, M., Peressoni, L., Piani, T., Colaetta, T., Mesaglio, M., Mattiussi, E., & Palese, A. (2021). Nurses’ experiences of being recruited and transferred to a new sub‐intensive care unit devoted to COVID‐19 patients. Journal of Nursing Management, 29(5), 1149–1158. https://doi.org/10.1111/jonm.13253

Doehring, A. (2018). Three-party interactions between neurologists, patients and their companions in the seizure clinic. [Unpublished doctoral dissertation]. Loughborough University.

Driessen, A., Borgstrom, E., & Cohn, S. (2021). Ways of ‘being with’: Caring for dying patients at the height of the COVID-19 pandemic. Anthropology in Action, 28(1), 16–20. https://doi.org/10.3167/aia.2021.280103

Ekberg, S., Danby, S., Herbert, A., Bradford, N. K., & Yates, P. (2020). Affording opportunities to discuss deterioration in paediatric palliative care consultations: A conversation analytic study. BMJ Supportive & Palliative Care, 10(2). https://doi.org/10.1136/bmjspcare-2016-001130

Ellingson, L. L. (2002). The roles of companions in geriatric patient–interdisciplinary oncology team interactions. Journal of Aging Studies, 16(4), 361–382. https://doi.org/10.1016/S0890-4065(02)00071-3

Fage-Butler, A. M., & Jensen, M. N. (2017). The interpersonal dimension of online patient forums: How patients manage informational and relational aspects in response to posted questions. HERMES - Journal of Language and Communication in Business, 51, 21–38. https://doi.org/10.7146/hjlcb.v26i51.97435

Finset, A. (2021). Challenges for healthcare communication during the COVID-19 pandemic. Patient Education and Counseling, 104(2), 215–216. https://doi.org/10.1016/j.pec.2021.01.006

Ford, J., Hepburn, A., & Parry, R. (2019). What do displays of empathy do in palliative care consultations? Discourse Studies, 21(1), 22–37. https://doi.org/10.1177/1461445618814030

Hanna, J. R., Rapa, E., Dalton, L. J., Hughes, R., Quarmby, L. M., McGlinchey, T., Donnellan, W. J., Bennett, K. M., Mayland, C. R., & Mason, S. R. (2021). Health and social care professionals’ experiences of providing end of life care during the COVID-19 pandemic: A qualitative study. Palliative Medicine, 35(7), 1249–1257. https://doi.org/10.1177/02692163211017808

Harvey, A. (2020). Covid-19: Medical schools given powers to graduate final year students early to help NHS. BMJ, 368. https://doi.org/10.1136/bmj.m1227

Imlach, F., McKinlay, E., Middleton, L., Kennedy, J., Pledger, M., Russell, L., Churchward, M., Cumming, J., & McBride-Henry, K. (2020). Telehealth consultations in general practice during a pandemic lockdown: Survey and interviews on patient experiences and preferences. BMC Family Practice, 21(1). https://doi.org/10.1186/s12875-020-01336-1

Jett, J. (2021, February 5). Easing the pain of the pandemic with the kindness of strangers. The New York Times. https://www.nytimes.com/2021/02/05/world/asia/hong-kong-quarantine-covid.html

Jordan, R. E., Adab, P., & Cheng, K. K. (2020). Covid-19: Risk factors for severe disease and death. BMJ, 368. https://doi.org/10.1136/bmj.m1198

Kelly, A. (2009). Articulating tacit knowledge through analyses of recordings: Implications for competency assessment in the vocational education and training sector. In C. Wyatt-Smith & J. Cumming (Eds.), Educational assessment in the 21st century (pp. 245–262). Springer.

Koffman, J., Gross, J., Etkind, S. N., & Selman, L. E. (2020). Clinical uncertainty and Covid-19: Embrace the questions and find solutions. Palliative Medicine, 34(7), 829–831. https://doi.org/10.1177/0269216320933750

Landmark, A. M. D., Gulbrandsen, P., & Svennevig, J. (2015). Whose decision? Negotiating epistemic and deontic rights in medical treatment decisions. Journal of Pragmatics, 78, 54–69. https://doi.org/10.1016/j.pragma.2014.11.007

Larsson, E., Brattström, O., Agvald‐Öhman, C., Grip, J., Campoccia Jalde, F., Strålin, K., Nauclér, P., Oldner, A., Konrad, D., Persson, B. P., Eriksson, L. I., Mårtensson, J., & Karolinska Intensive Care COVID‐19 Study Group. (2021). Characteristics and outcomes of patients with COVID‐19 admitted to ICU in a tertiary hospital in Stockholm, Sweden. Acta Anaesthesiologica Scandinavica, 65(1), 76–81. https://doi.org/10.1111/aas.13694

Lim, Z. J., Subramaniam, A., Ponnapa Reddy, M., Blecher, G., Kadam, U., Afroz, A., Billah, B., Ashwin, S., Kubicki, M., Bilotta, F., Curtis, J. R., & Rubulotta, F. (2021). Case fatality rates for patients with COVID-19 requiring invasive mechanical ventilation: A meta-analysis. American Journal of Respiratory and Critical Care Medicine, 203(1), 54–66. https://doi.org/10.1164/rccm.202006-2405OC

Lindström, A., & Weatherall, A. (2015). Orientations to epistemics and deontics in treatment discussions. Journal of Pragmatics, 78, 39–53. https://doi.org/10.1016/j.pragma.2015.01.005

Liu, Q., Luo, D., Haase, J. E., Guo, Q., Wang, X. Q., Liu, S., Xia, L., Liu, Z., Yang, J., & Yang, B. X. (2020). The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. The Lancet Global Health, 8(6), 790–798. https://doi.org/10.1016/S2214-109X(20)30204-7

Lwin, M. O., Lee, S. Y., Panchapakesan, C., & Tandoc, E. (2021). Mainstream news media’s role in public health communication during crises: Assessment of coverage and correction of COVID-19 misinformation. Health Communication. https://doi.org/10.1080/10410236.2021.1937842

Mahase, E. (2021). Delta variant: What is happening with transmission, hospital admissions, and restrictions? BMJ, 373. https://doi.org/10.1136/bmj.n1513

Mahtani, S. (2021, August 20). Singapore starts to reopen for travel, as ‘zero covid’ clips wings of rival Hong Kong. Washington Post. https://www.washingtonpost.com/world/asia_pacific/covid-quarantine-singapore-hong-kong/2021/08/20/35b9044e-00df-11ec-87e0-7e07bd9ce270_story.html

Mills, M. C., & Salisbury, D. (2021). The challenges of distributing COVID-19 vaccinations. EClinicalMedicine, 31. https://doi.org/10.1016/j.eclinm.2020.100674

Moorhead, S. A. (2017). Social media for healthcare communication. In Oxford Research Encyclopedia of Communication. https://doi.org/10.1093/acrefore/9780190228613.013.335

Paramasivan, A., & Khoo, D. (2020). Standardized patients versus peer role play—Exploring the experience, efficacy, and cost-effectiveness in residency training module for breaking bad news. Journal of Surgical Education, 77(2), 479–484. https://doi.org/10.1016/j.jsurg.2019.10.009

Parry, R., Land, V., & Seymour, J. (2014). How to communicate with patients about future illness progression and end of life: A systematic review. BMJ Supportive & Palliative Care, 4(4), 331–341. https://doi.org/10.1136/bmjspcare-2014-000649

Perakyla, A. (1998). Authority and accountability: The delivery of diagnosis in primary health care. Social Psychology Quarterly, 61(4), 301–320. https://doi.org/10.2307/2787032

Pilnick, A., Trusson, D., Beeke, S., O’Brien, R., Goldberg, S., & Harwood, R. H. (2018). Using conversation analysis to inform role play and simulated interaction in communications skills training for healthcare professionals: Identifying avenues for further development through a scoping review. BMC Medical Education, 18(1). https://doi.org/10.1186/s12909-018-1381-1

Pilnick, A., & Zayts, O. (2016). Advice, authority and autonomy in shared decision-making in antenatal screening: The importance of context. Sociology of Health & Illness, 38(3), 343–359. https://doi.org/10.1111/1467-9566.12346

Pino, M., & Parry, R. (2019). Talking about death and dying: Findings and insights from five conversation analytic studies. Patient Education and Counseling, 102(2), 185–187. https://doi.org/10.1016/j.pec.2019.01.011

Popkin, B. M., Du, S., Green, W. D., Beck, M. A., Algaith, T., Herbst, C. H., Alsukait, R. F., Alluhidan, M., Alazemi, N., & Shekar, M. (2020). Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships. Obesity Reviews, 21(11). https://doi.org/10.1111/obr.13128

Pun, J., Chan, E. A., Eggins, S., & Slade, D. (2020). Training in communication and interaction during shift-to-shift nursing handovers in a bilingual hospital: A case study. Nurse Education Today, 84. https://doi.org/10.1016/j.nedt.2019.104212

Robinson, E., Boyland, E., Chisholm, A., Harrold, J., Maloney, N. G., Marty, L., Mead, B. R., Noonan, R., & Hardman, C. A. (2021). Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults. Appetite, 156. https://doi.org/10.1016/j.appet.2020.104853

Rossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., & Di Lorenzo, G. (2020). COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00790

Ruusuvuori, J. (2005). “Empathy” and “sympathy” in action: Attending to patients’ troubles in Finnish homeopathic and general practice consultations. Social Psychology Quarterly, 68(3), 204–222. https://doi.org/10.1177/019027250506800302

Sen-Crowe, B., Sutherland, M., McKenney, M., & Elkbuli, A. (2021). A closer look into global hospital beds capacity and resource shortages during the COVID-19 pandemic. Journal of Surgical Research, 260, 56–63. https://doi.org/10.1016/j.jss.2020.11.062

Shaw, S. E., Seuren, L. M., Wherton, J., Cameron, D., A’Court, C., Vijayaraghavan, S., Morris, J., Bhattacharya, S., & Greenhalgh, T. (2020). Video consultations between patients and clinicians in diabetes, cancer, and heart failure services: Linguistic ethnographic study of video-mediated interaction. Journal of Medical Internet Research, 22(5). https://doi.org/10.2196/18378

Smith, K. (2021, October 1). COVID-19: Edmonton doctor recounts calling woman to share her mom’s dying moments. https://globalnews.ca/news/8235573/edmonton-doctor-icu-covid-19-death-tweets/

Soosaipillai, G., Archer, S., Ashrafian, H., & Darzi, A. (2020). Breaking bad news training in the COVID-19 era and beyond. Journal of Medical Education and Curricular Development, 7. https://doi.org/10.1177/2382120520938706

Stivers, T. (2005). Parent resistance to physicians’ treatment recommendations: One resource for initiating a negotiation of the treatment decision. Health Communication, 18(1), 41–74. https://doi.org/10.1207/s15327027hc1801_3

Stokoe, E. (2013). The (in)authenticity of simulated talk: Comparing role-played and actual interaction and the implications for communication training. Research on Language & Social Interaction, 46(2), 165–185. https://doi.org/10.1080/08351813.2013.780341

Surayya, A. (2021, September 3). Coping with COVID-19: Online support group provides emotional lifeline for refugee women. UNHCR. https://www.unhcr.org/en-my/news/latest/2021/9/6131dbb64/coping-with-covid-19-online-support-group-provides-emotional-lifeline-for.html

Swann, O. V., Holden, K. A., Turtle, L., Pollock, L., Fairfield, C. J., Drake, T. M., Seth, S., Egan, C., Hardwick, H. E., Halpin, S., Girvan, M., Donohue, C., Pritchard, M., Patel, L. B., Ladhani, S., Sigfrid, L., Sinha, I. P., Olliaro, P. L., Nguyen-Van-Tam, J. S., … Semple, M. G. (2020). Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: Prospective multicentre observational cohort study. BMJ, 370. https://doi.org/10.1136/bmj.m3249

Tam, F., Lindberg, K. S., & Hong, J. (2021, October 26). Hong Kong tightens quarantine rules in bid to open to China. https://www.bloomberg.com/news/articles/2021-10-26/hong-kong-to-remove-most-quarantine-exemptions-carrie-lam-says-kv7h20wi

Teh, C. (2021, May 20). When medical diagnoses miss the mark and their families don’t believe them, some COVID long-haulers turn to online groups for help. Insider. https://www.insider.com/covid-long-haulers-are-turning-to-online-groups-for-help-2021-4

Torjesen, I. (2021). Covid-19: Omicron may be more transmissible than other variants and partly resistant to existing vaccines, scientists fear. BMJ, 375. https://doi.org/10.1136/bmj.n2943

Tsang, H. F., Chan, L. W. C., Cho, W. C. S., Yu, A. C. S., Yim, A. K. Y., Chan, A. K. C., Ng, L. P. W., Wong, Y. K. E., Pei, X. M., Li, M. J. W., & Wong, S.-C. C. (2021). An update on COVID-19 pandemic: The epidemiology, pathogenesis, prevention and treatment strategies. Expert Review of Anti-Infective Therapy, 19(7), 877–888. https://doi.org/10.1080/14787210.2021.1863146

UK Research and Innovation. (2021, October 25). The story behind the Oxford-AstraZeneca COVID-19 vaccine success. https://www.ukri.org/our-work/tackling-the-impact-of-covid-19/vaccines-and-treatments/the-story-behind-the-oxford-astrazeneca-covid-19-vaccine-success/

University College London. (2020, April 1). Covid-19: UCL’s medical students join frontline NHS as doctors [Press release]. https://www.ucl.ac.uk/news/medical-students

University Grants Committee. (2021). UGC allocates another $100 million to support research related to COVID-19 and other novel infectious diseases [Press release]. https://www.ugc.edu.hk/eng/ugc/about/press_speech_other/press/2021/pr20210118.html

van Uden-Kraan, C. F., Drossaert, C. H. C., Taal, E., Shaw, B. R., Seydel, E. R., & van de Laar, M. A. F. J. (2008). Empowering processes and outcomes of participation in online support groups for patients with breast cancer, arthritis, or fibromyalgia. Qualitative Health Research, 18(3), 405–417. https://doi.org/10.1177/1049732307313429

Wang, A. B., Diamond, D., & Dreier, H. (2021, December 19). Health officials say omicron variant likely to cause record-high coronavirus cases, hospitalizations in U.S. The Washington Post. https://www.washingtonpost.com/health/2021/12/19/fauci-warns-omicron-variant-will-cause-record-high-coronavirus-hospitalizations-deaths-us/

Watson, B., & Gallois, C. (2007). Language, discourse, and communication about health and illness: Intergroup relations, role, and emotional support. In A. Weatherall, B. Watson, & C. Gallois (Eds.), Language, Discourse and Social Psychology (pp. 108–130). Palgrave Macmillan UK. https://doi.org/10.1057/9780230206168_5

Wells, C. R., Townsend, J. P., Pandey, A., Moghadas, S. M., Krieger, G., Singer, B., McDonald, R. H., Fitzpatrick, M. C., & Galvani, A. P. (2021). Optimal COVID-19 quarantine and testing strategies. Nature Communications, 12(1). https://doi.org/10.1038/s41467-020-20742-8

Wherton, J., Shaw, S., Papoutsi, C., Seuren, L., & Greenhalgh, T. (2020). Guidance on the introduction and use of video consultations during COVID-19: Important lessons from qualitative research. BMJ Leader, 4(3), 120–123. https://doi.org/10.1136/leader-2020-000262

White, S. J., Barello, S., Cao di San Marco, E., Colombo, C., Eeckman, E., Gilligan, C., Graffigna, G., Jirasevijinda, T., Mosconi, P., Mullan, J., Rehman, S. U., Rubinelli, S., Vegni, E., & Krystallidou, D. (2021). Critical observations on and suggested ways forward for healthcare communication during COVID-19: PEACH position paper. Patient Education and Counseling, 104(2), 217–222. https://doi.org/10.1016/j.pec.2020.12.025

Wu, Y. (2021). Empathy in nurse-patient interaction: A conversation analysis. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00535-0

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2022-07-06

How to Cite

Edmonds, D. M., Zayts-Spence, O., & Alder, K. (2022). Commentary: Communicating in crisis: Reflections, opportunities, and challenges for healthcare communication in the COVID-19 pandemic. Qualitative Health Communication, 1(2), 104–117. https://doi.org/10.7146/qhc.v1i2.128540

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Vol. 1 No. 2 (2022)

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Commentary

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