Zhonglin Chen1, Gan He2, Yi Zhao1, Chenyan Han1, Lei Xu1, Hong Jian1, Qiao Chu3, Yaping He4,5. 1. Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Rd, Shanghai, 200030, China. 2. School of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227 South Chongqing Rd, Shanghai, 200025, China. 3. School of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227 South Chongqing Rd, Shanghai, 200025, China. qiaochu@shsmu.edu.cn. 4. School of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227 South Chongqing Rd, Shanghai, 200025, China. hypcyr@shsmu.edu.cn. 5. Center for Health Technology Assessment, Shanghai Jiao Tong University China Hospital Development Institute, Shanghai Jiao Tong University, No. 227 South Chongqing Rd, Shanghai, 200025, China. hypcyr@shsmu.edu.cn.
Abstract
PURPOSE: The elevated physical symptom burden in advanced lung cancer can disrupt patients' emotional well-being, and current literature suggests that physicians' good communication skills might be a buffer. However, little is known about for which group of patients this buffering effect is most effective. Based on a cross-sectional study in patients with advanced lung cancer, the present study examined whether the moderating effect of physicians' communication skills on the association between physical symptoms and emotional distress would further depend on patients' perceived disease understanding. METHODS: Patients with advanced lung cancer (n = 199) completed a questionnaire including measures of physical symptoms related to lung cancer, anxiety, and depressive symptoms, perceptions of physicians' communication skills, and self-reported understanding of their disease. RESULTS: Hierarchical regression analyses indicated a significant three-way interaction among physical symptoms, perceptions of physicians' communication skills, and perceived disease understanding on both anxiety and depression. Specifically, physicians' good communication skills exerted a buffering effect only for patients with lower levels of disease understanding. CONCLUSION: Our findings indicate that improving physicians' communication skills may be especially beneficial for reducing the maladaptive emotional reactions to symptom burden for patients with limited disease understanding. When time and resources for communication are restricted, enhanced awareness and focused training may be directed at communicating with patients who possess limited knowledge about their disease.
PURPOSE: The elevated physical symptom burden in advanced lung cancer can disrupt patients' emotional well-being, and current literature suggests that physicians' good communication skills might be a buffer. However, little is known about for which group of patients this buffering effect is most effective. Based on a cross-sectional study in patients with advanced lung cancer, the present study examined whether the moderating effect of physicians' communication skills on the association between physical symptoms and emotional distress would further depend on patients' perceived disease understanding. METHODS: Patients with advanced lung cancer (n = 199) completed a questionnaire including measures of physical symptoms related to lung cancer, anxiety, and depressive symptoms, perceptions of physicians' communication skills, and self-reported understanding of their disease. RESULTS: Hierarchical regression analyses indicated a significant three-way interaction among physical symptoms, perceptions of physicians' communication skills, and perceived disease understanding on both anxiety and depression. Specifically, physicians' good communication skills exerted a buffering effect only for patients with lower levels of disease understanding. CONCLUSION: Our findings indicate that improving physicians' communication skills may be especially beneficial for reducing the maladaptive emotional reactions to symptom burden for patients with limited disease understanding. When time and resources for communication are restricted, enhanced awareness and focused training may be directed at communicating with patients who possess limited knowledge about their disease.
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