Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania.
Cancer. 2011 Jun 1;117(11):2569-76. doi: 10.1002/cncr.25804. Epub 2011 Jan 10.
Past research has linked patient-physician communication with improved emotional, physical, and social health. One component of communication, patient-clinician information engagement (PCIE), predicts improved short-term patient-reported outcomes, such as treatment satisfaction, through perceptions of feeling informed. However, to the authors' knowledge, the relation between PCIE and longer term cancer-related problems has not been examined previously. The authors examined the influence of PCIE on self-reported problems associated with cancer diagnosis and treatment based on a longitudinal survey among a randomly selected sample from the 2005 Pennsylvania Cancer Registry.
In total, 1293 respondents were surveyed who were diagnosed with colorectal, breast, or prostate cancers during 2006 and 2007. The baseline response rate was 64%, and the retention rate was 65%. The authors predicted an index of cancer-related problems at 1-year follow-up with the baseline cancer-related problem index and PCIE, controlling for demographic and clinical factors using regression analyses. The mean age of participants was 65 years, approximately 50% were women, and 86% were white.
Having more cancer-related problems and PCIE at baseline significantly predicted more cancer-related problems at follow-up. In addition, baseline cancer-related problems and PCIE interacted significantly (P = .01): PCIE was associated with more cancer-related problems at follow-up among participants who reported more symptoms rather than fewer symptoms at baseline.
If respondents reported engaging more with their physicians at baseline, then they reported experiencing more cancer-related issues at follow-up; this pattern was stronger among those who reported more baseline problems. The current results indicated that increased discussion of cancer information with physicians may maintain the salience of these problems in cancer survivors' minds over time.
既往研究表明医患沟通与改善情绪、身体和社会健康有关。沟通的一个组成部分,即医患信息互动(PCIE),通过患者感觉知情的感知来预测短期患者报告结果(如治疗满意度)的改善。然而,据作者所知,PCIE 与长期癌症相关问题之间的关系以前尚未被检验过。作者通过对宾夕法尼亚癌症登记处 2005 年随机选择的样本进行的纵向调查,检验了 PCIE 对与癌症诊断和治疗相关的自我报告问题的影响。
共有 1293 名被诊断患有结直肠癌、乳腺癌或前列腺癌的受访者在 2006 年和 2007 年接受了调查。基线响应率为 64%,保留率为 65%。作者使用回归分析,根据人口统计学和临床因素,预测了基线癌症相关问题指数和 PCIE 对 1 年随访时癌症相关问题的影响。参与者的平均年龄为 65 岁,约 50%为女性,86%为白人。
基线时更多的癌症相关问题和 PCIE 显著预测了随访时更多的癌症相关问题。此外,基线时癌症相关问题和 PCIE 之间存在显著的交互作用(P =.01):与基线时报告症状较少的患者相比,在基线时报告症状较多的患者中,PCIE 与随访时更多的癌症相关问题相关。
如果患者在基线时报告与医生的互动更多,那么他们在随访时报告更多的癌症相关问题;这种模式在基线问题较多的患者中更为明显。目前的结果表明,与医生讨论更多的癌症信息可能会随着时间的推移,使这些问题在癌症幸存者的头脑中保持突出。