Association of Patient–Provider Communication Domains with Lung Cancer Treatment

Abstract

Background Patient-physician communication is critical for helping patients understand and complete the complex steps needed to diagnose stage and treat lung cancer. We assessed which domains of patient-physician communication about lung cancer and its treatment are associated with receipt of disease-directed, stage-appropriate treatment. Methods Patients with recently-diagnosed lung cancer were recruited from four medical centers in New York City from 2008 to 2011. Participants were surveyed about discussions with physicians regarding treatment, symptoms and needs. Multiple regression analysis and structural equation modeling were used to assess which communication factors were associated with disease treatment. Results Of the 352 participants, 191 (54%) received disease-directed, stage-appropriate treatment. Unadjusted associations between communication items and treatment found that participants who felt that their physicians explained the risks and disadvantages of lung cancer treatment (P<0.01), discussed their chances of cure (P=0.02), discussed goals of treatment (P<0.01) or who were warm and friendly (P=0.04) were more likely to undergo treatment. Three communication domains were identified: treatment information, physician support, and patient symptoms/needs. After adjusting for known determinants of lung cancer treatment, increased treatment information was associated with higher probability of cancer-directed treatment (P=0.003). Other communication domains (physician support or patient symptoms/needs) were not independent predictors of treatment (P>0.05 for both comparisons). Conclusions These data suggest that treatment information is particularly important for increasing the probability of cancer-directed therapy among lung cancer patients. Clinicians should ensure that they clearly discuss treatment goals and options with patients while maintaining empathy, supporting patient needs, and addressing symptoms.

The Impact of Preexisting Mental Health Disorders on the Diagnosis, Treatment, and Survival among Lung Cancer Patients in the U.S. Military Health System

“…This study only evaluated receipt of treatment, but adherence to treatment recommendations may differ between patients with vs. without mental health disorders, which may contribute to the overall survival difference. Finally, mental health disorders may affect interactions and communications between patients and their providers and patient-provider communications has been shown to influence clinical outcomes in lung cancer patients (21, 58, 59)…”

Experience of nursing support from the perspective of patients with cancer in mainland China

“…First, we can infer that by carefully listening to and clearly understanding patients’ views, nurses can help bridge the gap between patients’ expectations and the support provided by healthcare professionals, especially regarding active communication. An increasing number of international studies have consistently indicated that communication between patients and healthcare providers is critical for helping patients to express their concerns and report their needs and for adherence to cancer treatment (Schofield et al ., ; Lin et al ., ). In contrast, the lack of active communication might exacerbate patients’ reluctance to express their needs and the nurses’ difficulty in identifying latent issues that could deteriorate patients’ health.…”

Experiences of cancer patients in Poland throughout diagnosis and treatment

“…Medical information should be provided in a way that the patient understands the message and accepts the treatment (Lin et al . ; Papadakos et al . ).…”

“…The way information is provided to the patient must be adapted to the individual patient and their family and they must be given an opportunity to ask questions (Kwok & White 2014;Li et al 2014;Rudolph et al 2015). Medical information should be provided in a way that the patient understands the message and accepts the treatment (Lin et al 2014;Papadakos et al 2014). Both the kind of information and the amount of data that can be provided to a particular person at one time must be considered.…”