Determinants of patient activation in a community sample of breast and prostate cancer survivors

Abstract

Background Patient activation—the knowledge, skills and confidence to manage one’s health—is associated with improved self-management behaviors for several chronic conditions. This study assesses rates of patient activation in breast and prostate cancer survivors and explores the characteristics associated with patient activation. Methods A cross-sectional study of survivors with localized (Stage I or II) breast and prostate cancers who are post-treatment (between 1–10+ years) were recruited from four community-hospital sites in New Jersey. Survey data on patient characteristics (demographic and psychosocial) and clinical factors were assessed to the explore relationships with patient activation using the Patient Activation Measure (PAM-13). Results Among 325 survivors (112 prostate; 213 breast) overall patient activation was high (M=3.25). Activation was significantly lower among prostate survivors when compared to breast cancer survivors (M=3.25 [SD 0.38] vs. M=3.34 [SD 0.37], p <0.05). For prostate survivors, race (p< 0.05), marital status (p<0.001), employment status (p<0.01), household income (p<0.05), and fear of recurrence (p<0.01) were significantly associated with patient activation. For both groups ease of access to oncology team and primary care physicians (PCPs) (all p-values < 0.001) and perceptions of time spent with oncologists team and PCPs (all P-values <.01) were positive predictors of activation. Conclusions In both breast and prostate survivors’ access to providers (both PCPs and oncologists) and perception that adequate time spent with providers were associated with activation. Therefore, clinical interventions maybe a promising avenue to improve patient activation. Research is needed to develop and test tailored patient activation interventions to improve self-management among cancer survivors.

Determinants of patient activation and its association with cardiovascular disease risk in chronic kidney disease: A cross‐sectional study

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Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates

“…Patients with greater HA felt less satisfied with: a) the information they received [62] b) their care and the medical decisions they made [146,234], and c) were less confident they had received good treatment [137]. They also reported lower patient activation (i.e., the knowledge, skills, and confidence to manage one's health) [153] This suggests that the medical team may play an important role in the management of HA in this population.…”

Racial Disparities in Patient Activation: The Role of Economic Diversity

“…Unfortunately, certain groups such as ethnic/racial minorities (National Center for Health Statistics, 2016), individuals with low income (United States Census Bureau, 2019b), and individuals with low educational attainment (Eneanya et al, 2016) have a higher proportion of disease burden compared to Whites, top income earners, and college graduates (Coylewright et al, 2014; O’Malley et al, 2018; Singh-Manoux et al, 2003). Indeed, there are a constellation of factors that determine health.…”

“…Western Journal of Nursing Research 43(6) et al, 2016) have a higher proportion of disease burden compared to Whites, top income earners, and college graduates (Coylewright et al, 2014;O'Malley et al, 2018;Singh-Manoux et al, 2003). Indeed, there are a constellation of factors that determine health.…”