Barriers and facilitators to discussing HPV with head and neck cancer patients: A qualitative study using the theoretical domains framework

M O'Connor; J Waller; P Gallagher; B O'Donovan; N Clarke; I Keogh; D MacCarthy; E O'Sullivan; C Timon; C Martin; J O'Leary; L Sharp

doi:10.1016/j.pec.2020.05.032

Barriers and facilitators to discussing HPV with head and neck cancer patients: A qualitative study using the theoretical domains framework

Patient Educ Couns. 2020 May 30:S0738-3991(20)30318-9. doi: 10.1016/j.pec.2020.05.032. Online ahead of print.

Authors

M O'Connor¹, J Waller², P Gallagher³, B O'Donovan⁴, N Clarke³, I Keogh⁵, D MacCarthy⁶, E O'Sullivan⁷, C Timon⁸, C Martin⁹, J O'Leary⁹, L Sharp¹⁰

Affiliations

¹ National Cancer Registry Ireland, Kinsale Road, Cork, Ireland.
² Department of Behavioural Science and Health, University College London, London, UK.
³ School of Psychology, Dublin City University, Dublin, Ireland.
⁴ National Cancer Registry Ireland, Kinsale Road, Cork, Ireland. Electronic address: BEODONOV@tcd.ie.
⁵ College of Medicine Nursing & Health Sciences, National University of Ireland Galway, Ireland.
⁶ Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Dublin, Ireland.
⁷ Cork University Dental School and Hospital, Cork, Ireland.
⁸ St. James's Hospital, James's Street, Dublin, Ireland.
⁹ Department of Histopathology, University of Dublin, Trinity College, Ireland; Department of Pathology, Coombe Women and Infants University Hospital, Ireland.
¹⁰ Institute of Health & Society, Newcastle University, UK.

PMID: 32565003
DOI: 10.1016/j.pec.2020.05.032

Abstract

Objective: The incidence of human papillomavirus-associated head and neck cancers (HPV-HNC) is increasing worldwide. Research in other clinical contexts has shown that healthcare professionals (HCPs) can find discussing HPV with patients challenging. However, limited research has been conducted in HNC. This study aimed to investigate barriers and facilitators to, discussing HPV among HCPs caring for patients with HNC in Ireland.

Methods: Semi-structured telephone/face-to-face interviews were conducted with HCPs. Barriers and facilitators to discussing HPV with patients were identified using the Theoretical Domains Framework (TDF).

Results: 20 HCPs (8 clinicians, 3 nurses, 9 allied healthcare professionals) were interviewed. Barriers to discussing HPV included professionals' lack of HPV knowledge, difficulties in talking about sexual issues with patients and lack of privacy to discuss HPV in busy clinic settings. Facilitators included increasing public and patient awareness of the link between HPV and HNC and professional education and skills development.

Conclusions: This is the first theoretically informed study to identify barriers and facilitators to discussing HPV with HNC patients. HCPs consider HPV discussions to be an essential part of HNC patient care.

Practice implications: Understanding the issues associated with patient-provider HPV communication will help develop effective interventions to support HCPs in their HPV discussions.

Keywords: Barriers; Facilitators; HPV; HPV discussions; Head and neck cancer; Healthcare professionals; Patients.