Implications for patient-provider communication and health self-efficacy among cancer survivors with multiple chronic conditions: results from the Health Information National Trends Survey

Abstract

Purpose: Cancer survivors with multiple chronic conditions experience significant challenges managing their health. The six core functions of patient-centered communication (PCC)-fostering healing relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient self-management-represent a central component to facilitating a survivor's confidence to manage their health that has not been investigated in cancer survivors with multiple chronic conditions.

Method: Nationally representative data across two iterations of the Health Information National Trends Survey (HINTS) were merged with combined replicate weights using the jackknife replication method. Adjusted linear regression examined the association between PCC and health self-efficacy in a sample of breast, colorectal, and prostate cancer survivors and by multiple chronic conditions.

Results: 53.9% reported that providers did not always respond to their emotions and 48.9% reported that they could not always rely on their providers to help them manage uncertainty. In the adjusted linear regression models, there was a significant positive association between PCC and health self-efficacy (β = 0.2, p = 0.01) for the entire sample. However, the association between PCC and health self-efficacy was attenuated in cancer survivors with multiple chronic conditions (β = 0.1, p = 0.53).

Conclusion: PCC alone is not enough to improve a cancer survivor's confidence in their ability to manage their health in the presence of multiple chronic conditions.

Implications for cancer survivors: Cancer survivors with multiple chronic conditions need ongoing support, in addition to PCC, that render them prepared to manage their health after cancer.

Keywords: Cancer survivorship; Multiple chronic conditions; Patient-provider communication; Self-efficacy.