Moments of connection between clinicians and patients in oncology: A mixed-methods exploratory study of sacred moments.

Abstract

e21004 Background: Sacred moments – brief periods of deep interconnectedness between clinicians and patients – have been associated with enhanced well-being and therapeutic alliance. While these moments have been described in radiation oncology and general hospital patients, they have been unexplored in medical oncology, where relationship-centered care is particularly crucial. We thus assessed the frequency and themes around sacred moments experienced by clinicians caring for patients with cancer. Methods: We conducted an exploratory, mixed methods study at an NCI-designated Comprehensive Cancer Center through purposeful sampling of clinicians. Participants completed a semi-structured interview and a survey. Interviews were recorded, transcribed, and de-identified. Thematic analysis was performed on textual data of transcripts using an inductive coding approach. The survey assessed demographics, frequency of sacred moments, and their impact. Using a 5-point Likert scale, participants rated how these moments influenced career fulfillment, sense of meaning, and connection with patients. Results: We interviewed 24 clinicians: attendings (70%), fellows (20%), and advanced practice providers (10%). Of 23 survey respondents, specialties included medical oncology (65%), hematology (13%), surgical oncology (13%), and palliative medicine (9%). A majority of participants were female (65%), with a range of experience (56% 0-10 years, 43% >10 years’ in practice). All 24 clinicians reported having experienced a sacred moment during a patient encounter in their career, with 95% of participants reporting at least monthly occurrences. All agreed these moments enhanced their professional fulfillment, allowed for connection with their patients, and reminded them of why they went into their career. Three main themes emerged from the qualitative interviews: 1) Sacred moment catalysts: changes in patient clinical status, continuity of patient-clinician relationships 2) Cultivation strategies: intentional presence, partnership with the patient, recognizing shared humanity, and 3) Career fulfillment: sense of purpose, increased likelihood of goal aligned care with patients (Table 1). Conclusions: Sacred moments among oncology clinicians are common, professionally fulfilling, and serve as a reminder of why they pursued oncology. Future work will examine the patient perspective and developing interventions to increase the frequency of these meaningful interactions. Themes and illustrative quotes. Catalysts “I followed her for several years, and suddenly she very rapidly deteriorated. We stood together and sobbed.” Cultivation “ My principle if I go into the room is I’m going to spend as much time as that patient needs, and share some human interaction.” Fulfillment “It’s what's kept me enjoying the practice of medicine.” “Feels more like what medicine is supposed to be.”