Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
JCO Oncol Pract. 2022 May;18(5):e786-e796. doi: 10.1200/OP.22.00005.
The triad of communication between young adult childhood cancer survivors (YACCSs), their parents, and their medical providers is an important process in managing health care engagement. This study sought to identify communication patterns among this triad, factors associated with communication, and engagement of survivorship care.
We analyzed data from Project Forward, a population-based study that surveyed YACCSs and their parents. YACCSs were on average age 20 years, 7 years from diagnosis, 50% female, and 57% identified as Hispanic/Latino (N = 160 dyads). Latent class analysis of nine communication indicators from parent and YACCS surveys identified distinct classes of communication between YACCSs, parents, and medical providers. Associations between resulting classes and YACCS/parent characteristics were examined using multinomial logistic regression. Logistic regression was used to examine the association between communication classes and cancer-related follow-up care.
Latent class analysis identified three classes of triad communication: (1) high health care-focused communication (37.5%), (2) high comprehensive communication (15.6%), and (3) overall low communication (46.9%). After adjusting for covariates, greater time since diagnosis was associated with reduced odds of membership in class 2 while dyads with Spanish-speaking Hispanic parents were more likely to be in class 2 ( class 3). Additionally, YACCSs who were in either of the high communication groups were more likely to have received recent follow-up care.
Examining language preference provides an important contextual understanding as we found Spanish-speaking Hispanic parents engaged in high communication, which was associated with cancer-related follow-up care. Yet, our results also support the need to enhance communication between this triad to improve outcomes.
青少年癌症幸存者(YACCS)与其父母和医疗服务提供者之间的三方沟通是管理医疗保健参与的重要过程。本研究旨在确定三方之间的沟通模式、与沟通相关的因素以及生存护理的参与情况。
我们分析了“向前项目”的数据,该项目是一项基于人群的研究,调查了 YACCS 及其父母。YACCS 的平均年龄为 20 岁,距诊断时间为 7 年,50%为女性,57%为西班牙裔/拉丁裔(N=160 对)。对来自父母和 YACCS 调查的 9 个沟通指标的潜在类别分析确定了 YACCS、父母和医疗服务提供者之间沟通的不同类别。使用多项逻辑回归检查得出的类别与 YACCS/父母特征之间的关联。使用逻辑回归检查沟通类别与癌症相关随访护理之间的关联。
潜在类别分析确定了三方沟通的三个类别:(1)高度关注医疗保健的沟通(37.5%),(2)高度全面的沟通(15.6%),以及(3)整体沟通水平较低(46.9%)。调整协变量后,诊断后时间越长,类别 2 的成员资格的可能性降低,而讲西班牙语的西班牙裔父母的家庭更有可能属于类别 2(类别 3)。此外,属于任何高沟通组的 YACCS 更有可能接受最近的随访护理。
检查语言偏好提供了一个重要的背景理解,因为我们发现讲西班牙语的西班牙裔父母进行了高沟通,这与癌症相关的随访护理相关。然而,我们的研究结果还支持需要加强三方之间的沟通,以改善结果。