University of Illinois at Chicago Institute for Health Research and Policy, 1747 W. Roosevelt Rd., Chicago, IL, 60608, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair St., Chicago, IL, 60611, USA.
Support Care Cancer. 2021 Apr;29(4):1913-1921. doi: 10.1007/s00520-020-05674-9. Epub 2020 Aug 15.
We explored relationships between patient-provider communication quality (PPCQ) and three quality of life (QOL) domains among self-identified rural cancer survivors: social well-being, functional well-being, and physical well-being. We hypothesized that high PPCQ would be associated with greater social and functional well-being, but be less associated with physical well-being, due to different theoretical mechanisms.
All data were derived from the 2017-2018 Illinois Rural Cancer Assessment (IRCA). To measure PPCQ and QOL domains, we respectively used a dichotomous measure from the Medical Expenditure Panel Survey's Experience Cancer care tool (high, low/medium) and continuous measures from the Functional Assessment of Cancer Therapy-General (FACT-G).
Our sample of 139 participants was largely female, non-Hispanic White, married, and economically advantaged. After adjusting for demographic and clinical variables, patients who reported high PPCQ exhibited greater social well-being (Std. β = 0.20, 95% CI: 0.03, 0.35, p = 0.02) and functional well-being (Std. β = 0.20, 95% CI: 0.05, 0.35, p = 0.03) than patients with low/medium PPCQ. No association was observed between PPCQ and physical well-being (Std. β = 0.06, 95% CI: - 2.51, 0.21, p = 0.41). Sensitivity analyses found similar, albeit attenuated, patterns.
Our findings aligned with our hypotheses. Future researchers should explore potential mechanisms underlying these differential associations. Specifically, PPCQ may be associated with social and functional well-being through interpersonal mechanisms, but may not be as associated with physical well-being due to multiple contextual factor rural survivors disproportionately face (e.g., limited healthcare access, economic hardship) and stronger associations with clinical factors.
我们探讨了患者与提供者沟通质量(PPCQ)与三个生活质量(QOL)领域之间的关系,这些领域是自我认同的农村癌症幸存者:社会福祉、功能福祉和身体福祉。我们假设,由于不同的理论机制,高 PPCQ 与更大的社会和功能福祉相关,但与身体福祉的相关性较低。
所有数据均来自 2017-2018 年伊利诺伊州农村癌症评估(IRCA)。为了测量 PPCQ 和 QOL 领域,我们分别使用来自医疗支出面板调查的经验癌症护理工具的二分法测量(高、低/中)和来自癌症治疗一般功能评估的连续测量(FACT-G)。
我们的 139 名参与者样本主要是女性、非西班牙裔白人、已婚和经济上处于优势地位。在调整人口统计学和临床变量后,报告高 PPCQ 的患者表现出更大的社会福祉(标准β=0.20,95%CI:0.03,0.35,p=0.02)和功能福祉(标准β=0.20,95%CI:0.05,0.35,p=0.03)比 PPCQ 低/中患者。在 PPCQ 与身体福祉之间没有观察到关联(标准β=0.06,95%CI:-2.51,0.21,p=0.41)。敏感性分析发现了类似的、尽管有所减弱的模式。
我们的研究结果与我们的假设一致。未来的研究人员应该探索这些差异关联的潜在机制。具体来说,PPCQ 可能通过人际机制与社会和功能福祉相关,而由于农村幸存者面临的多种情境因素(例如,有限的医疗保健机会、经济困难)和与临床因素的更强关联,与身体福祉的关联可能较弱。