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Patients’ Trust in Physician, Patient Enablement, and Health-Related Quality of Life During Colon Cancer Treatment

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Abstract

In cancer care, where patients and their families experience significant emotional distress and patients have to deal with complex medical information, patient centeredness is an important aspect of quality of care. The aim of this study is to examine the impact of patients’ trust in their oncologists and patients’ enablement on changes in health-related quality of life of colon cancer patients during follow-up care. We conducted a prospective study in a representative sample of private practices of German oncologists (N = 44). Patients (N = 131) filled out a standardized questionnaire prior to their first consultation (T0), directly after the first consultation (T1) and after two months (T2). Data were analyzed by structural equation modeling. Significant associations were found between trust in physician and changes in physical functioning between T1 and T2, and between trust in physician and patient enablement. Patient enablement is significantly associated with changes in physical functioning between T1 and T2. The results underline the importance of building a close and trustful patient-physician relationship in the oncology encounter. A central mechanism of the association between the quality of the relationship and health outcomes seems to be patient enablement. To enable patients to cope with their situation by making them understand their diagnosis, treatments, and side effects can impact health-related quality of life in physical domains.

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Acknowledgements

This study was funded by a grant from the German Research Foundation (Grant No: PF 407/4-1). The authors wish to thank the patients and physicians for their participation and intensive collaboration.

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Authors and Affiliations

  1. Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany

    Nicole Ernstmann

  2. Department for Research Methodology, University of Education, Kunzenweg 21, 79117, Freiburg, Germany

    Markus Wirtz

  3. Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Strasse 129, 50933, Cologne, Germany

    Anika Nitzsche, Sophie E. Gross, Lena Ansmann, Tristan D. Gloede, Julia Jung & Holger Pfaff

  4. Scientific Institute of Office-Based Haematologists and Oncologists, WINHO , Vor den Siebenburgen 2, 50676, Cologne, Germany

    Walter Baumann

  5. Professional Organization of Office-Based Haematologists and Oncologists e.V. (BNHO), Sachsenring 69, 50677, Cologne, Germany

    Stephan Schmitz

  6. Institute for Integrative Medicine, Department for Psychology/Psychotherapy, Department for Medicine, Faculty of Health, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany

    Melanie Neumann

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  1. Nicole Ernstmann
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  2. Markus Wirtz
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  4. Sophie E. Gross
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  11. Melanie Neumann
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Corresponding author

Correspondence to Nicole Ernstmann.

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The study was reviewed and approved by the Ethics Committee of the Medical Faculty of the University of Cologne. All physicians and patients participating in the study gave written informed consent.

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Ernstmann, N., Wirtz, M., Nitzsche, A. et al. Patients’ Trust in Physician, Patient Enablement, and Health-Related Quality of Life During Colon Cancer Treatment. J Canc Educ 32, 571–579 (2017). https://doi.org/10.1007/s13187-017-1166-y

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