Abstract
Purpose
We explored relationships between patient-provider communication quality (PPCQ) and three quality of life (QOL) domains among self-identified rural cancer survivors: social well-being, functional well-being, and physical well-being. We hypothesized that high PPCQ would be associated with greater social and functional well-being, but be less associated with physical well-being, due to different theoretical mechanisms.
Methods
All data were derived from the 2017–2018 Illinois Rural Cancer Assessment (IRCA). To measure PPCQ and QOL domains, we respectively used a dichotomous measure from the Medical Expenditure Panel Survey’s Experience Cancer care tool (high, low/medium) and continuous measures from the Functional Assessment of Cancer Therapy-General (FACT-G).
Results
Our sample of 139 participants was largely female, non-Hispanic White, married, and economically advantaged. After adjusting for demographic and clinical variables, patients who reported high PPCQ exhibited greater social well-being (Std. β = 0.20, 95% CI: 0.03, 0.35, p = 0.02) and functional well-being (Std. β = 0.20, 95% CI: 0.05, 0.35, p = 0.03) than patients with low/medium PPCQ. No association was observed between PPCQ and physical well-being (Std. β = 0.06, 95% CI: − 2.51, 0.21, p = 0.41). Sensitivity analyses found similar, albeit attenuated, patterns.
Conclusion
Our findings aligned with our hypotheses. Future researchers should explore potential mechanisms underlying these differential associations. Specifically, PPCQ may be associated with social and functional well-being through interpersonal mechanisms, but may not be as associated with physical well-being due to multiple contextual factor rural survivors disproportionately face (e.g., limited healthcare access, economic hardship) and stronger associations with clinical factors.
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Funding
This study has been funded by the Center for Research on Women and Gender, University of Illinois at Chicago and the University of Illinois Cancer Center. The corresponding author (Dr. Molina) was financially supported by the National Cancer Institute, K01CA193918. Dr. Strayhorn would like to acknowledge the funding of the National Cancer Institute, T32CA057699.
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Each participant provided informed consent prior to their enrollment.
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All procedures involving study participants were in accordance with the ethical standards of the institutional review board of the University of Illinois Cancer Center Protocol Review Committee as well as the University of Illinois at Chicago Institutional Review Board.
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Strayhorn, S.M., Lewis-Thames, M.W., Carnahan, L.R. et al. Assessing the relationship between patient-provider communication quality and quality of life among rural cancer survivors. Support Care Cancer 29, 1913–1921 (2021). https://doi.org/10.1007/s00520-020-05674-9
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DOI: https://doi.org/10.1007/s00520-020-05674-9