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癌症幸存者在 COVID-19 大流行之前和早期期间的患者为中心的沟通效果不佳。

Cancer survivors with sub-optimal patient-centered communication before and during the early COVID-19 pandemic.

机构信息

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.

出版信息

Patient Educ Couns. 2023 Oct;115:107876. doi: 10.1016/j.pec.2023.107876. Epub 2023 Jun 28.

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

We observed that the decreased prevalence of optimal PCC, and identified those with suboptimal PCC during COVID-19.

PRACTICE IMPLICATIONS

More efforts to raise awareness and improve PCC are suggested, including education and guidelines, given the decreased prevalence during this public health emergency.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

实践意义

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb5/10299944/4cf9141144fb/gr1_lrg.jpg

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