Kathryn A Martinez1, Ken Resnicow2, Geoffrey C Williams3, Marlene Silva4, Paul Abrahamse5, Dean A Shumway6, Lauren P Wallner7, Steven J Katz8, Sarah T Hawley9. 1. Cleveland Clinic, Center for Value-Based Care Research, 9500 Euclid Ave, G10 Cleveland, OH 44195, USA. Electronic address: martink12@ccf.org. 2. University of Michigan School of Public Health, 109 Observatory Street Ann Arbor, MI 48109-2029, USA. Electronic address: kresnic@umich.edu. 3. University of Rochester, School of Medicine, 500 Joseph C. Wilson Blvd Rochester, NY 14611, USA. Electronic address: Geoffrey_Williams@URMC.Rochester.edu. 4. University of Lisbon, Faculty of Human Kinetics, Estrada da Costa, 1495-710, Cruz Quebrada, Lisbon, Portugal. Electronic address: mnsilva@fmh.ulisboa.pt. 5. University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: pabraham@med.umich.edu. 6. University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: dshumway@med.umich.edu. 7. University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: lwallner@med.umich.edu. 8. University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: skatz@med.umich.edu. 9. University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: sarahawl@med.umich.edu.
Abstract
OBJECTIVE: Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. METHODS: Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). RESULTS: Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. CONCLUSION: Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. PRACTICE IMPLICATIONS: Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality.
OBJECTIVE: Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. METHODS: Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). RESULTS: Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. CONCLUSION: Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. PRACTICE IMPLICATIONS: Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality.
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