Department of Public Health Sciences, University of California Davis, Davis, CA, USA; Stanford Center for Digital Health, Stanford Medicine, Stanford, CA, USA.
Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA.
Patient Educ Couns. 2023 Oct;115:107876. doi: 10.1016/j.pec.2023.107876. Epub 2023 Jun 28.
Patient-Centered Communication (PCC) is an essential element of patient-centered cancer care. Thus, this study aimed to examine the prevalence of and factors associated with optimal PCC among cancer survivors during COVID-19, which has been less studied.
We used national survey (Health Information National Trends Survey) among cancer survivors (n = 2579) to calculate the prevalence (%) of optimal PCC in all 6 PCC domains and overall (mean) by time (before COVID-19, 2017-19 vs. COVID-19, 2020). Multivariable logistic regressions were performed to explore the associations of sociodemographic (age, birth gender, race/ethnicity, income, education, usual source of care), and health status (general health, depression/anxiety symptoms, time since diagnosis, cancer type) factors with optimal PCC.
The prevalence of optimal PCC decreased during COVID-19 overall, with the greatest decrease in managing uncertainty (7.3%). Those with no usual source of care (odd ratios, ORs =1.53-2.29), poor general health (ORs=1.40-1.66), depression/anxiety symptoms (ORs=1.73-2.17) were less likely to have optimal PCC in most domains and overall PCC.
We observed that the decreased prevalence of optimal PCC, and identified those with suboptimal PCC during COVID-19.
More efforts to raise awareness and improve PCC are suggested, including education and guidelines, given the decreased prevalence during this public health emergency.
以患者为中心的沟通（PCC）是患者为中心的癌症护理的一个重要组成部分。因此，本研究旨在研究 COVID-19 期间癌症幸存者中最佳 PCC 的流行情况和相关因素，这方面的研究较少。
我们使用全国性调查（健康信息国家趋势调查）对癌症幸存者（n=2579）进行了分析，以计算在所有 6 个 PCC 领域以及总体（平均值）中，最佳 PCC 的流行率（%），并根据时间（COVID-19 之前，2017-19 年与 COVID-19 期间，2020 年）进行划分。采用多变量逻辑回归来探讨社会人口统计学（年龄、出生性别、种族/民族、收入、教育、常规医疗来源）和健康状况（总体健康、抑郁/焦虑症状、诊断后时间、癌症类型）因素与最佳 PCC 的关联。
在 COVID-19 期间，整体最佳 PCC 的流行率下降，不确定性管理方面的下降最大（7.3%）。没有常规医疗来源的患者（优势比，ORs=1.53-2.29）、一般健康状况较差的患者（ORs=1.40-1.66）、有抑郁/焦虑症状的患者（ORs=1.73-2.17）在大多数领域和总体 PCC 中不太可能获得最佳 PCC。
我们观察到最佳 PCC 的流行率下降，并确定了 COVID-19 期间 PCC 不佳的患者。
鉴于在此公共卫生紧急情况下流行率下降，建议加强提高认识和改善 PCC 的努力，包括教育和指南。
