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

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 helping 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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Authors and Affiliations

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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

Keywords

  • Patient-centered care
  • Patient-provider communication
  • Cancer survivorship
  • Emotions
  • Uncertainty