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The association between a patient-centered quality of care index and self-efficacy among cancer survivors

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Abstract

Purpose

The number of cancer survivors in the US surpassed 18.1 million in 2022 and this number continues to grow. Patient self-efficacy, a patient’s confidence in his or her ability to self-manage symptoms and healthcare concerns, has been linked to improved health outcomes. We thus set out to examine the association between a patient-centered care quality index and self-efficacy among cancer survivors.

Methods

Data from 777 survivors of breast, prostate, and colorectal cancers at 32 cancer centers nationwide were collected 6 months after an initial survivorship visit. Patients completed surveys assessing patient-centered care (36 items under seven factors) and individual self-efficacy (eight items). Multiple linear regression was used to examine the association between patient-centered care and patient self-efficacy, adjusting for demographics, cancer-related characteristics, and organizational characteristics of high-quality patient-centered survivorship care.

Results

In descriptive analyses, there were no statistically significant differences in demographic or cancer-related characteristics between cancer survivors by quality of patient-centered care. In regression models, a one-unit increase in patient-centered care was associated with a 0.23 (95% CI 0.14–0.32) increase in mean self-efficacy compared to low quality of patient-centered care when adjusting for demographics, cancer-related characteristics, and indicators of high-quality survivorship care. Individually, four of the seven factors of quality patient-centered care were statistically significantly associated with greater self-efficacy. Having a medical home was associated with the greatest increase in self-efficacy among survivors.

Conclusion

Our findings indicate that higher quality patient-centered care is associated with greater cancer survivor self-efficacy. Given that self-efficacy is correlated with improved health outcomes and quality of life, this finding further supports the importance of high-quality patient-centered survivorship care.

Implications of Cancer Survivors

High-quality patient-centered survivorship care was associated with higher patient self-efficacy. This association should further be explored among cancer survivors with diverse characteristics.

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Data availability

Data is available upon reasonable request to the corresponding author.

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Funding

Funding for the study was provided by the Patient-Centered Outcomes Research Institute (PCORI IH-12–11-5255).

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Authors and Affiliations

  1. Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, 5 E. 98th St. B-12, New York, NY, 10029, USA

    Brittany Engelman

  2. George Washington University Cancer Center, Washington, DC, USA

    Mandi L. Pratt-Chapman

  3. Department of Medicine, George Washington University, School of Medicine and Health Sciences, Washington, DC, USA

    Mandi L. Pratt-Chapman

  4. School of Public Health, George Washington University, Washington, DC, USA

    K. Holly Mead

  5. Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA

    Yan Wang

  6. Medstar Health Research Institute, Healthcare Delivery Research, Washington, DC, USA

    Hannah Arem

  7. Department of Oncology, Georgetown University, Washington, DC, USA

    Hannah Arem

Authors
  1. Brittany Engelman
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  2. Mandi L. Pratt-Chapman
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  3. K. Holly Mead
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  4. Yan Wang
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  5. Hannah Arem
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Contributions

B.E. was responsible for the analyses and drafting the initial version of the manuscript.

M.L.PC. was responsible for funding, conceptualizing the project, and providing feedback on the draft.

KHM was responsible for funding and providing feedback on the draft.

YW advised on statistical analyses and contributed to the final version of the manuscript.

HA was responsible for overseeing analysis and drafting of the manuscript.

All authors reviewed the final manuscript.

Corresponding author

Correspondence to Brittany Engelman.

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The authors declare no competing interests.

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Engelman, B., Pratt-Chapman, M.L., Mead, K.H. et al. The association between a patient-centered quality of care index and self-efficacy among cancer survivors. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01581-8

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