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Trends in cancer survivors’ experience of patient-centered communication: results from the Health Information National Trends Survey (HINTS)- abstract
Purpose
Two
Institute of Medicine reports almost a decade apart suggest that cancer
survivors often feel “lost in transition” and experience suboptimal
quality of care. The six core functions of patient-centered
communication: managing uncertainty, responding to emotions, making
decisions, fostering healing relationships, enabling self-management,
and exchanging information, represent a central aspect of survivors’
care experience that has not been systematically investigated.
Methods
Nationally
representative data from four administrations of the Health Information
National Trends Survey (HINTS) was merged with combined replicate
weights using the jackknife replication method. Linear and logistic
regression models were used to assess (1) characteristics of cancer
survivors (N = 1794) who report
suboptimal patient-centered communication and (2) whether survivors’
patient-centered communication experience changed from 2007 to 2013.
Results
One
third to one half of survivors report suboptimal patient-centered
communication, particularly on core functions of providers helping
manage uncertainty (48 %) and responding to emotions (49 %). In a fully
adjusted linear regression model, survivors with more education, without a usual source of care, and in poorer health
were more likely to report less patient-centered communication.
Although ratings of patient-centered communication improved over time, this trend did not remain significant in fully adjusted models.
Conclusions
Despite
increased attention to survivorship, many survivors continue to report
suboptimal communication with their health care providers.
Implications for Cancer Survivors
Survivorship
communication should include managing uncertainty about future risk and
address survivors’ emotional needs. Efforts to improve patient-centered
communication should focus on survivors without a usual source of care
and in poorer health.
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