Cancer survivors' disclosure of complementary health approaches to physicians: the role of patient-centered communication

Cancer. 2015 Mar 15;121(6):900-7. doi: 10.1002/cncr.29138. Epub 2014 Nov 11.

Abstract

Background: Cancer survivors' disclosure of complementary health approaches (CHAs) to their follow-up care physicians is necessary to ensure the safe and optimal use of such approaches. Rates of disclosure of CHAs are variable and may be facilitated by patient-centered communication.

Methods: This cross-sectional study conducted in 2003-2004 examined a population-based sample of leukemia, colorectal, and bladder cancer survivors (n=623) who were 2 to 5 years after their diagnosis. A subset of participants who reported using CHAs (n=196) was analyzed with multivariate logistic regression to examine the association between patients' perceptions of their physician's patient-centered communication (ie, information exchange, affective behavior, knowledge of patients as persons) and patients' disclosure of CHA use to their physician with adjustments for physician, patient, and patient-physician relationship factors.

Results: Thirty-one percent of the full sample used CHAs, and 47.6% of CHA users disclosed their use to their physicians. Disclosure was significantly associated with patient-centered communication even with adjustments for hypothesized covariates (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.09-1.71). Perceived physician knowledge of the patient as a person (OR, 1.28; 95% CI, 1.10-1.48) and information exchange (OR, 1.27; 95% CI, 1.02-1.60) were the aspects of patient-centered communication that contributed to this association. The main reason for nondisclosure assessed in the survey was that survivors did not think that it was important to discuss CHAs (67.0%). A majority of physicians encouraged continued use of CHAs when they were disclosed (64.8%).

Conclusions: Results support the idea that improving the overall patient centeredness of cancer follow-up care and improving the disclosure of CHA use are potentially synergistic clinical goals.

Keywords: communication; complementary medicine; complementary therapies; neoplasms; patient-centered care; survivors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / psychology
  • Colorectal Neoplasms / therapy
  • Communication
  • Complementary Therapies / psychology
  • Complementary Therapies / statistics & numerical data*
  • Cross-Sectional Studies
  • Data Collection
  • Female
  • Humans
  • Leukemia / psychology
  • Leukemia / therapy
  • Male
  • Middle Aged
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Physician-Patient Relations*
  • Physicians
  • Self Disclosure*
  • Surveys and Questionnaires
  • Survivors / psychology*
  • Urinary Bladder Neoplasms / psychology
  • Urinary Bladder Neoplasms / therapy
  • Young Adult