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Trends in cancer survivors’ experience of patient-centered communication: results from the Health Information National Trends Survey (HINTS)

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Abstract

Purpose

Two Institute of Medicine reports almost a decade apart suggest that cancer survivors often feel “lost in transition” and experience suboptimal quality of care. The six core functions of patient-centered communication: managing uncertainty, responding to emotions, making decisions, fostering healing relationships, enabling self-management, and exchanging information, represent a central aspect of survivors’ care experience that has not been systematically investigated.

Methods

Nationally representative data from four administrations of the Health Information National Trends Survey (HINTS) was merged with combined replicate weights using the jackknife replication method. Linear and logistic regression models were used to assess (1) characteristics of cancer survivors (N = 1794) who report suboptimal patient-centered communication and (2) whether survivors’ patient-centered communication experience changed from 2007 to 2013.

Results

One third to one half of survivors report suboptimal patient-centered communication, particularly on core functions of providers hel** manage uncertainty (48 %) and responding to emotions (49 %). In a fully adjusted linear regression model, survivors with more education (Wald F = 2.84, p = .04), without a usual source of care (Wald F = 11.59, p < .001), and in poorer health (Wald F = 9.08, p < .001) were more likely to report less patient-centered communication. Although ratings of patient-centered communication improved over time (p trend = .04), this trend did not remain significant in fully adjusted models.

Conclusions

Despite increased attention to survivorship, many survivors continue to report suboptimal communication with their health care providers.

Implications for Cancer Survivors

Survivorship communication should include managing uncertainty about future risk and address survivors’ emotional needs. Efforts to improve patient-centered communication should focus on survivors without a usual source of care and in poorer health.

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References

  1. In: Levit L, Balogh E, Nass S, Ganz PA, editors. Delivering high-quality cancer care: charting a new course for a system in crisis. Washington (DC)2013.

  2. Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. Washington: National Academies Press; 2006.

    Google Scholar 

  3. Ganz PA, Earle CC, Goodwin PJ. Journal of Clinical Oncology update on progress in cancer survivorship care and research. J Clin Oncol. 2012;30(30):3655–6.

    Article  PubMed  Google Scholar 

  4. Nekhlyudov L, Levit L, Hurria A, Ganz PA. Patient-centered, evidence-based, and cost-conscious cancer care across the continuum: Translating the Institute of Medicine report into clinical practice. CA Cancer J Clin. 2014;64(6):408–21.

    Article  PubMed  Google Scholar 

  5. Commission on Cancer. Cancer program standards 2012: ensuring patient-centered care. V1.0. Chicago, IL: American College of Surgeons; 2012.

  6. Epstein RM, Street RL. Patient communication in cancer care: promoting healing and reducing suffering. (NIH Publication No 07–6225). Bethesda: National Cancer Institute; 2007.

    Google Scholar 

  7. Fogarty LA, Curbow BA, Wingard JR, McDonnell K, Somerfield MR. Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol: Off J Am Soc Clin Oncol. 1999;17(1):371–9.

    CAS  Google Scholar 

  8. Mallinger JB, Griggs JJ, Shields CG. Patient-centered care and breast cancer survivors’ satisfaction with information. Patient Educ Couns. 2005;57(3):342–9.

    Article  PubMed  Google Scholar 

  9. Thorne SE, Stajduhar KI. Patient perceptions of communications on the threshold of cancer survivorship: implications for provider responses. J Cancer Surviv. 2012;6(2):229–37.

    Article  PubMed  Google Scholar 

  10. Epstein RM, Street RLJ. Patient-centered communication in cancer care: promoting healing and reducing suffering. Bethesda, MD: NIH Publication No. 07–6225; 2007.

  11. Nelson DE, Kreps GL, Hesse BW, Croyle RT, Willis G, Arora NK, et al. The Health Information National Trends Survey (HINTS): development, design, and dissemination. J Health Commun. 2004;9(5):443–60.

    Article  PubMed  Google Scholar 

  12. McCormack LA, Treiman K, Rupert D, Williams-Piehota P, Nadler E, Arora NK, et al. Measuring patient-centered communication in cancer care: a literature review and the development of a systematic approach. Soc Sci Med. 2011;72(7):1085–95.

    Article  PubMed  Google Scholar 

  13. Arora NK, Reeve BB, Hays RD, Clauser SB, Oakley-Girvan I. Assessment of quality of cancer-related follow-up care from the cancer survivor’s perspective. J Clin Oncol. 2011;29(10):1280–9.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Forsythe LP, Alfano CM, Leach CR, Ganz PA, Stefanek M, Rowland JH. Who provides psychosocial follow-up care for post-treatment cancer survivors?: a survey of medical oncologists and primary care physicians. J Clin Oncol. 2012;30(23):2897–905.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Adler N, Page A, editors. Cancer care for the whole patient: meeting psychosocial healthcare needs. Washington DC: Institute of Medicine (IOM). 2008.

  16. Koch L, Bertram H, Eberle A, Holleczek B, Schmid-Höpfner S, Waldmann A, et al. Fear of recurrence in long-term breast cancer survivors—still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the cancer survivorship—a multi-regional population-based study. Psycho-Oncology. 2014;23(5):547–54.

    Article  PubMed  Google Scholar 

  17. Clayton MF, Dudley WN. Patient-centered communication during oncology follow-up visits for breast cancer survivors: content and temporal structure. Oncol Nurs Forum. 2009;36(2):E68–79.

    Article  PubMed  Google Scholar 

  18. Blanch-Hartigan D, Chawla N, Beckjord EI, Forsythe LP, de Moor JS, Hesse BW, et al. Cancer survivors’ receipt of treatment summaries and implications for patient-centered communication and quality of care. Patient Educ Couns. 2015;98(10):1274–9.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Salz T, Oeffinger KC, McCabe MS, Layne TM, Bach PB. Survivorship care plans in research and practice. CA Cancer J Clin. 2012.

  20. Ayanian JZ, Zaslavsky AM, Guadagnoli E, Fuchs CS, Yost KJ, Creech CM, et al. Patients’ perceptions of quality of care for colorectal cancer by race, ethnicity, and language. J Clin Oncol. 2005;23(27):6576–86.

    Article  PubMed  Google Scholar 

  21. Teno JM, Lima JC, Lyons KD. Cancer patient assessment and reports of excellence: reliability and validity of advanced cancer patient perceptions of the quality of care. J Clin Oncol. 2009;27(10):1621–6.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Connectedness and continuity: patient-provider relationships among low-income Californians. Blue Cross Blue Shield of California Foundation, 2012.

  23. Finney Rutten LJ, Agunwamba AA, Beckjord E, Hesse BW, Moser RP, Arora NK. The relation between having a usual source of care and ratings of care quality: does patient-centered communication play a role? J Health Commun. 2015;20(7):759–65.

    Article  PubMed  Google Scholar 

  24. Blanch-Hartigan D, Forsythe LP, Alfano CM, Smith T, Nekhlyudov L, Ganz PA, et al. Provision and discussion of survivorship care plans among cancer survivors: results of a nationally representative survey of oncologists and primary care physicians. J Clin Oncol. 2014;32(15):1578–85.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Oeffinger KC, McCabe MS. Models for delivering survivorship care. J Clin Oncol. 2006;24(32):5117–24.

    Article  PubMed  Google Scholar 

  26. Hall JA, Horgan TG, Stein TS, Roter DL. Liking in the physician-patient relationship. Patient Educ Couns. 2002;48(1):69–77.

    Article  PubMed  Google Scholar 

  27. Shulman LN, Ferris L, Takanishi DM, McKellar D. Treatment summaries and survivorship care plans: the approach by the commission on cancer to increase use. J Oncol Pract. 2014.

  28. Mazor KM, Gaglio B, Nekhlyudov L, Alexander GL, Stark A, Hornbrook MC, et al. Assessing patient-centered communication in cancer care: stakeholder perspectives. J Oncol Pract. 2013;9(5):e186–93.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ross L, Petersen MA, Johnsen AT, Lundstrøm LH, Groenvold M. Cancer patients’ evaluation of communication: a report from the population-based study ‘The Cancer Patient’s World’. Support Care Cancer. 2013;21(1):235–44.

    Article  PubMed  Google Scholar 

  30. Parry C, Kent EE, Mariotto AB, Alfano CM, Rowland JH. Cancer survivors: a booming population. Cancer Epidemiol Biomarkers Prev. 2011;20(10):1996–2005.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ganz PA. Delivering on the promise of patient-centered care. J Natl Compr Canc Netw. 2015;13(4):495–7.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Natural and Applied Sciences, Bentley University, Jennison 103, 175 Forest Street, Waltham, MA, 02452, USA

    Danielle Blanch-Hartigan

  2. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Neetu Chawla

  3. Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Richard P. Moser & Bradford W. Hesse

  4. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA

    Lila J. Finney Rutten

  5. Improving Health Systems, Patient-Centered Outcomes Research Institute, Washington, DC, USA

    Neeraj K. Arora

Authors
  1. Danielle Blanch-Hartigan
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  2. Neetu Chawla
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  3. Richard P. Moser
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  4. Lila J. Finney Rutten
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  5. Bradford W. Hesse
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  6. Neeraj K. Arora
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Corresponding author

Correspondence to Danielle Blanch-Hartigan.

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Funding

The Health Information National Trends Survey is supported by contract number HHSN26120100064C from the National Cancer Institute. The views expressed in the manuscript do not necessarily represent the views of the US Federal Government.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Blanch-Hartigan, D., Chawla, N., Moser, R.P. et al. Trends in cancer survivors’ experience of patient-centered communication: results from the Health Information National Trends Survey (HINTS). J Cancer Surviv 10, 1067–1077 (2016). https://doi.org/10.1007/s11764-016-0550-7

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  • DOI: https://doi.org/10.1007/s11764-016-0550-7

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