Confidence in the ability to communicate with physicians among low-income patients with prostate cancer

Maliski, Sally L.; Kwan, Lorna; Krupski, Tracey L.; Fink, Arlène; Orecklin, James R.; Litwin, Mark S.

doi:10.1016/j.urology.2004.03.042

Cited by 52 publications

(48 citation statements)

References 28 publications

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“…16 In contrast, men with low education in the VA CaPSURE sample had worse HRQOL outcomes than those of general samples, and were similar to those men seen outside the VA, but cared for in clinical settings that provide care to patients of lower socioeconomic status. [17][18][19] Previous work on social disparities in health outcomes has found that those of lower socioeconomic status experience poor HRQOL outcomes and greater symptom burden. 10 However, few prostate cancer investigations have focused on the relation between education and HRQOL outcomes.…”

Section: Discussionmentioning

confidence: 99%

Education predicts quality of life among men with prostate cancer cared for in the department of Veterans affairs

Knight

Latini

Hart

et al. 2007

Cancer

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BACKGROUND.Previous findings have suggested that patient educational attainment is related to cancer stage at presentation and treatment for localized prostate cancer, but there is little information on education and quality of life outcomes. Patient education level and quality of life were examined among men diagnosed with prostate cancer and cared for within an equal‐access health care system, the Department of Veterans Affairs Veterans Health Administration (VA).METHODS.Participants were 248 men with prostate cancer cared for in the VA and enrolled in CaPSURE. Repeated‐measures analysis of variance was used to examine quality of life over time according to education level, controlling for age, ethnicity, income, site of clinical care, and year of diagnosis.RESULTS.Patients with lower levels of education tended to be younger, nonwhite, and have lower incomes. Controlling for age, ethnicity, income, year of diagnosis, and site, men with less formal education, compared with those with more, had worse functioning in the physical (P = .0248), role physical (P = .0048), role emotional (P = .0089), vitality (P = .0034), mental health (P = .0054), social function (P = .0056), and general health (P = .0002) domains and worse urinary (P = .003) and sexual (P = .0467) side effects.CONCLUSIONS.Men with less education experienced worse health‐related quality of life across a wide range of domains and greater urinary and sexual symptoms than their peers who had more education. Clinicians should be aware that, even within an equal access to health care system, men with less education are vulnerable, having greater difficulty functioning in their daily lives after their prostate cancer treatment. Cancer 2007. © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Education predicts quality of life among men with prostate cancer cared for in the department of Veterans affairs

Knight

Latini

Hart

et al. 2007

Cancer

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“…The first stage of PST -problem orientation -may be the most critical for ethnic minorities and underserved populations due to the emphasis on personal control beliefs or self-efficacy [65,66] and identifying negative thoughts [67,68]. We find that successful advancement through PST stages is significantly dependent on pre-therapy clinical strategies: establishing a solid therapeutic alliance through rapport-building; application of motivational interviewing strategies [69]; providing assistance with practical needs (e.g., transportation, applying for disability insurance; facilitating receipt of financial assistance for cancer treatment; and childcare/caregiving issues); and addressing system barriers (i.e.…”

Section: Intervention Designmentioning

confidence: 99%

Improving treatment of depression among low-income patients with cancer: the design of the ADAPt-C study

Ell¹,

Quon²,

Quinn³

et al. 2007

General Hospital Psychiatry

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Objective-This paper describes the randomized clinical trial methodology for a population based study of oncology patients receiving cancer care in a public sector medical center. The primary goal is to test the effectiveness of socioculturally tailored collaborative care intervention in improving depression and quality of life outcomes among low-income ethnic minority patients with major depression and cancer.Methods-The PHQ-9 depression scale was used to identify patients meeting criteria for major depression (1 cardinal depression symptom + a PHQ-9 score of ≥ 10). Study eligible patients were ≥90 days from cancer diagnosis who were receiving acute cancer treatment or follow-up care in oncology clinics. Patients with advanced disease limiting life expectancy to <6 months, acutely suicidal or on antipsychotic medication were excluded. Allowing for attrition due to death or loss to follow-up, the study was powered at the 80% level to detect a 20% difference between study arms in the proportion of patients with ≥50% reduction in PHQ-9 symptoms at 12 months.Results-Of 2,330 patients screened, 23.2% met criteria. An 82.4% enrollment rate resulted in 447 primarily women being recruited and randomized to intervention or usual care. Conclusion-The study applies methods used in primary care depression trials with adaptations for oncology care clinics and for low-income minority patients.

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“…Further, although patient self-efficacy in communicating with physicians has not been investigated in the context of delayed care, it has been shown to predict receipt of BC knowledge, 33 receipt of breast reconstructive surgery, 34 decreased BC treatmentrelated symptoms, 35 and quality of life in low-income prostate cancer patients. 36 Ability to adequately interface with the healthcare system and healthcare providers, which could minimize diagnostic delay, may be particularly compromised in low-income, less-educated populations of women.…”

mentioning

confidence: 99%

What Influences Diagnostic Delay in Low-Income Women with Breast Cancer?

Maly

Leake

Mojica

et al. 2011

Journal of Women's Health

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Background: Delayed diagnosis of breast cancer (BC) may contribute to adverse outcomes, such as reduced survival. The purpose of this study was to identify correlates of elapsed time between recognition of breast abnormalities and receipt of definitive diagnosis of BC among low-income women. Methods: Data were obtained from a cross-sectional study among a statewide sample of 921 low-income women with a new diagnosis of BC. Patients were grouped by whether their breast abnormalities were self-detected or healthcare system detected. Multivariate logistic regression analyses were used to examine associations between diagnostic delay and patient characteristics, patient communication, and system characteristics. Results: The self-detected group experienced much greater delay than the system-detected group (median intervals 80.5 vs. 31.5 days). African Americans had the longest intervals between symptom detection and diagnostic resolution; median delays in the self-detected and system-detected subgroups were 115 and 70 days, respectively, compared to 64 and 22 days for Caucasians. In multivariate analyses, African Americans had considerably greater odds of > 60-day delay than Caucasians in both the self-detected (odds ratio [OR] 3.51) and system-detected (OR 5.36) groups. Greater perceived self-efficacy in interacting with healthcare providers was significantly associated with shorter delay among the self-detected group (OR 0.86). Conclusions: Disparities in timely BC diagnosis between African Americans and Caucasians were pronounced in this uniformly low-income population of women. Women with self-detected abnormalities had markedly greater delays than those with healthcare system-detected abnormalities. Among this vulnerable group, increasing self-efficacy in interacting with healthcare providers may reduce diagnostic delays.

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Confidence in the ability to communicate with physicians among low-income patients with prostate cancer

Cited by 52 publications

References 28 publications

Education predicts quality of life among men with prostate cancer cared for in the department of Veterans affairs

Education predicts quality of life among men with prostate cancer cared for in the department of Veterans affairs

Improving treatment of depression among low-income patients with cancer: the design of the ADAPt-C study

What Influences Diagnostic Delay in Low-Income Women with Breast Cancer?

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