Elkefi Safa, Asan Onur
School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, USA.
J Patient Exp. 2023 Jan 17;10:23743735231151533. doi: 10.1177/23743735231151533. eCollection 2023.
Patient-centered approaches impact cancer patients' perceptions and outcomes in different ways. This study explores the impact of patient-centered care practices on cancer patients' quality-of-care (QOC), self-efficacy, and trust in their doctors. We utilized cross-sectional national survey data from the National Cancer Institute collected between 2017 and 2020. All estimates were weighted using the jackknife method. We used multivariable logistic regression to test our hypotheses adjusted for the demographics of the 1932 cancer patients that responded to the survey. Findings indicate that patient-centered communication resulted in better QOC, self-efficacy, and trust in doctors. In addition, engagement in their care improved patients' trust in cancer-related information received from doctors. QOC and patients' trust in doctors were significantly improved with the patients' understanding of the next steps, addressing feelings, clear explanation of the problems, spending enough time with the clinicians, addressing uncertainty, and involvement in decisions. Patients who were given a chance to ask questions were significantly more likely to trust their doctors. Technology use did not impact any of these interactions. Patient-centered strategies should consider the needs of the patients in the cancer settings to improve overall outcomes. Organizations should also build strategies that are goal-oriented and centered around the patients' needs, as standard strategies cannot induce the wanted results.
以患者为中心的方法以不同方式影响癌症患者的认知和治疗结果。本研究探讨了以患者为中心的护理实践对癌症患者护理质量(QOC)、自我效能感以及对医生信任度的影响。我们利用了美国国家癌症研究所2017年至2020年期间收集的全国横断面调查数据。所有估计值均采用刀切法进行加权。我们使用多变量逻辑回归来检验我们的假设,并针对1932名回复调查的癌症患者的人口统计学特征进行了调整。研究结果表明,以患者为中心的沟通带来了更好的护理质量、自我效能感以及对医生的信任。此外,参与自身护理提高了患者对从医生那里获得的癌症相关信息的信任度。当患者了解下一步计划、感受得到关注、问题得到清晰解释、与临床医生有足够的交流时间、不确定性得到解决以及参与决策时,护理质量和患者对医生的信任度得到了显著提高。有机会提问的患者更有可能信任他们的医生。技术的使用并未对这些互动产生任何影响。以患者为中心的策略应考虑癌症患者的需求,以改善总体治疗结果。各组织还应制定以患者需求为导向和核心的策略,因为标准策略无法产生预期效果。