City University of New York and Columbia University, Department of Health and Behavior Studies, Teachers College, 525W 120 St., New York, NY 10027, USA.
J Health Commun. 2010;15 Suppl 3:135-46. doi: 10.1080/10810730.2010.522701.
Patient-provider communication is an important element in cancer treatment and prevention. We examined the degree of concordance perceived to exist between the patient's preferences for inclusion in decision-making processes and their actual experiences among two population-based cohorts of U.S. adults with and without cancer histories who were surveyed in 2003 and 2007. Associations were examined between selected sociodemographic characteristics of respondents and the extent to which respondents perceived their health providers "always" involved them in decisions about their health to the extent desired. Data came from the Health Information National Trends Survey (HINTS), and SPSS and SAS-Callable SUDAAN statistical packages were used to analyze the data. Results showed a decrement in the proportion of favorable responses between 2003 and 2007. While there was no gender effect on the reported perceptions in either year, there was a significant effect of ethnicity (p = .001) in both years. Age, income, and employment were also independently associated (p = .001) in 2007. In contrast to 2003, higher education was significantly associated with communication satisfaction, as was having a cancer diagnosis, in 2007. There was a significant relationship between several sociodemographic variables and respondent perceptions about the consistency with which providers included patients as desired in decision-making. We conclude that communication between patient and provider remains suboptimal in cancer prevention and treatment.
医患沟通是癌症治疗和预防的一个重要环节。我们研究了美国两个基于人群的队列中,癌症患者和非癌症患者在 2003 年和 2007 年的调查中,患者对参与决策过程的偏好与实际经历之间的一致性程度。我们调查了受访者的一些社会人口学特征与他们认为医疗服务提供者在多大程度上“始终”按照他们的意愿参与他们的健康决策之间的关联。数据来自健康信息国家趋势调查(HINTS),使用 SPSS 和 SAS-Callable SUDAAN 统计软件包对数据进行分析。结果显示,在 2003 年至 2007 年期间,有利反应的比例有所下降。虽然在这两年中,性别对报告的看法没有影响,但在这两年中,种族(p=0.001)都有显著影响。年龄、收入和就业状况在 2007 年也有独立的相关性(p=0.001)。与 2003 年不同的是,在 2007 年,较高的教育程度与沟通满意度显著相关,同时也与癌症诊断显著相关。在 2007 年,一些社会人口学变量与受访者对提供者按照他们的意愿让患者参与决策的一致性的看法之间存在显著关系。我们的结论是,在癌症的预防和治疗中,医患沟通仍然不尽如人意。