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Support Care Cancer. 2018 May;26(5):1625-1633. doi: 10.1007/s00520-017-3992-1. Epub 2017 Dec 5.

Patient-clinician communication among patients with stage I lung cancer.

Author information

1
Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D66), 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA. Shannon.nugent@va.gov.
2
Division of Psychiatry, Oregon Health & Science University, Portland, OR, USA. Shannon.nugent@va.gov.
3
Center to Improve Veteran Involvement in Care, VA Portland Health Care System (R&D66), 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
4
Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
5
Division of Pulmonary & Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
6
Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System, Portland, OR, USA.
7
Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
8
Division of Clinical Research, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA.
9
Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.

Abstract

PURPOSE:

Limited data exist about patient-centered communication (PCC) and patient-centered outcomes among patients who undergo surgery or stereotactic body radiation therapy (SBRT) for stage I non-small cell lung cancer (NSCLC). We aimed to examine the relationship between PCC and decision-making processes among NSCLC patients, using baseline data from a prospective, multicenter study.

METHODS:

Patients with stage 1 NSCLC completed a survey prior to treatment initiation. The survey assessed sociodemographic characteristics, treatment decision variables, and patient psychosocial outcomes: health-related quality of life (HRQOL), treatment self-efficacy, decisional conflict, and PCC.

RESULTS:

Fifty-two percent (n = 85) of 165 individuals planned to receive SBRT. There were no baseline differences detected on patient psychosocial outcomes between those who planned to receive SBRT or surgery. All participants reported high HRQOL (M = 72.5, SD = 21.3) out of 100, where higher scores indicate better functioning; high self-efficacy (M = 1.5, SD = 0.5) out of 6, where lower numbers indicate higher self-efficacy; minimal decisional conflict (M = 15.2, SD = 12.7) out of 100, where higher scores indicate higher decisional conflict; and high levels of patient-centered communication (M = 2.4, SD = 0.8) out of 7 where higher scores indicate worse communication. Linear regression analyses adjusting for sociodemographic and clinical variables showed that higher quality PCC was associated with higher self-efficacy (β = 0.17, p = 0.03) and lower decisional conflict (β = 0.42, p < 0.001).

CONCLUSIONS:

Higher quality PCC was associated with higher self-efficacy and lower decisional conflict. Self-efficacy and decisional conflict may influence subsequent health outcomes. Therefore, our findings may inform future research and clinical programs that focus on communication strategies to improve these outcomes.

KEYWORDS:

Lung cancer; Patient-clinician communication; Psychosocial outcomes; Stereotactic radiation therapy

PMID:
29209835
DOI:
10.1007/s00520-017-3992-1

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