Quality of Patient-Provider Communication Among Cancer Survivors: Findings From a Nationally Representative Sample

Abstract

Purpose:Although patient-provider communication is an essential component of health care delivery, little is known about the quality of these discussions among patients with cancer.Methods:Data are from the 2011 Medical Expenditure Panel Survey Experiences with Cancer survey among 1,202 adult cancer survivors. We evaluated discussions with any provider after a cancer diagnosis about: (1) follow-up care; (2) late or long-term treatment effects; (3) lifestyle recommendations, such as diet, exercise, and quitting smoking; and (4) emotional or social needs. Using a response scale ranging from “did not discuss” to “discussed in detail,” a summary score was constructed to define communication quality as high, medium, or low. Patient factors associated with the quality of provider discussions were examined using multivariable polytomous logistic regression analyses.Results:At the time of the survey, approximately one half of the patients (46%) were either within 1 year (24.1%) or between 1 and 5 years (22.0%) of treatment. More than one third of cancer survivors reported that they did not receive detailed communication about follow-up care, and more than one half reported that they did not receive detailed communication regarding late or long-term effects, lifestyle recommendations, or emotional and social needs. Only 24% reported high-quality communication for all four elements, indicating that the vast majority experienced suboptimal communication. In multivariable analysis, survivors reporting a high communication quality with providers included those who were within 1 year of treatment, between the ages of 18 and 64 years, non-Hispanic black or other ethnicity, and married.Conclusion:Study findings demonstrate gaps in the communication quality experienced by cancer survivors in the United States and help identify survivors for targeted interventions.

Information needs and information seeking behaviour of patients during follow-up of colorectal cancer in the Netherlands

“…Previous studies have shown that CRC patients that have received dietary advice were more likely to change their diet, although lifestyle issued are not always adequately addressed by health care providers [20, 21]. Tan et al state that “clinicians could consider addressing issues including smoking cessation, physical activity, or other risk behaviours with their patients during the early survivorship period when patients are likely to be more receptive to information about managing risks of recurrence” [6].…”

COMFORT™SM communication for oncology nurses: Program overview and preliminary evaluation of a nationwide train-the-trainer course

“…One third to one half of cancer survivors report suboptimal patient-centered communication [30]. Recent research has identified gaps in this area, noting that cancer survivors are not given detailed communication about follow-up care, lifestyle recommendations, or social and emotional needs [31]. Future curriculum content development should address how nurses should relay news of recurrence and initiate discussions about quality of life that include physical, psychological, social, and spiritual well-being domains.…”

Impact of sociodemographic characteristics on underemployment in a longitudinal, nationally representative study of cancer survivors: Evidence for the importance of gender and marital status

“…Healthcare providers may also have a role to play in discussing expectations and decisions about cancer treatment and making appropriate referrals for rehabilitative, symptom management, and/or social work guided interventions. A recent nationally representative study of cancer survivors reported that less than half of cancer survivors report high quality discussions with providers, at any time following diagnosis, regarding late or long-term effects of cancer and treatment (Chawla, Blanch-Hartigan, & Virgo, 2016). Given the importance of work and the high levels of underemployment that many cancer survivors face, particularly married women, discussion about how cancer and its treatment may have an impact on work should be both systematically studied and recognized as a component of comprehensive survivorship care.…”