Navigating Disagreements on Health Information: How Patients With Cancer Perceive Health Care Providers' Approaches to Discussing Patient-Identified Information.

IF 4.6 3区 医学 Q1 ONCOLOGY
JCO oncology practice Pub Date : 2025-08-01 Epub Date: 2025-01-28 DOI:10.1200/OP.24.00071
Ilona Fridman, Cambray Smith, Amy Barrett, Skyler Johnson, Amrita Bhowmick, Sara Hayes, Jennifer Elston Lafata
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引用次数: 0

Abstract

Purpose: Although publicly available cancer-related information online and offline could help patients make informed decisions, it also poses challenges due to prevalent misinformation. Patients need proper provider guidance to ensure they use valid and relevant information in decisions. We identify effective communication approaches for providers when (1) discussing patient-identified information and (2) disagreeing with it.

Methods: From June to August 2023, people living with cancer were reached via online communities and asked first about their actual experiences discussing patient-identified information with their providers. Respondents were then randomly assigned into an experiment with three hypothetical scenarios where providers disagreed with patient-identified information. Provider responses included (1) dismissal, (2) explanation, and (3) explanation with relationship-building elements. Pearson correlation and multivariable analysis of variance were used to evaluate differences in patient perceptions.

Results: One hundred seventy-five respondents completed the survey. Mean age: 53 years; 45% female; and 88% White, 10% Black, and 2% others. Forty-six percent held Bachelor's degrees or higher, 11% lived rurally, 36% reported financial difficulties, and 46% rated their health as good/excellent. Between 31% and 37% of respondents reported their provider used communication approaches that negatively correlated with discussion outcomes. The approaches included avoidance of such conversations due to limited time, discouragement of future information searches, or judgmental comments. In the experiment, respondents randomly assigned to receive relationship-building elements were significantly more comfortable sharing information, felt more satisfied, respected, and trusted their provider's opinion more than those receiving the dismissal scenario. The explanation scenario was not perceived differently compared with the dismissal scenario.

Conclusion: More than a third of respondents reported negative communication when sharing patient-identified information with their provider. Provider prioritization of relationship-building alongside explanations could foster trust and facilitate open information exchange, supporting informed decisions.

在健康信息上的分歧导航:癌症患者如何感知医疗保健提供者讨论患者识别信息的方法。
目的:尽管在线和离线公开的癌症相关信息可以帮助患者做出明智的决定,但由于普遍存在的错误信息,它也带来了挑战。患者需要适当的提供者指导,以确保他们在决策中使用有效和相关的信息。当(1)讨论患者识别信息和(2)不同意它时,我们为提供者确定有效的沟通方法。方法:从2023年6月到8月,通过在线社区联系癌症患者,首先询问他们与提供者讨论患者身份信息的实际经历。然后,受访者被随机分配到一个实验中,有三个假设的场景,其中提供者不同意患者识别的信息。提供者的回应包括(1)解雇,(2)解释,以及(3)带有建立关系元素的解释。使用Pearson相关和多变量方差分析来评估患者感知的差异。结果:175名受访者完成了调查。平均年龄:53岁;45%的女性;88%是白人,10%是黑人,2%是其他人种。46%的人拥有学士学位或更高学位,11%的人住在农村,36%的人有经济困难,46%的人认为自己的健康状况良好/优秀。31%到37%的受访者表示,他们的供应商使用的沟通方式与讨论结果呈负相关。这些方法包括由于时间有限而避免这样的对话,不鼓励未来的信息搜索,或判断性的评论。在实验中,被随机分配到“建立关系”组的受访者明显比被解雇组更愿意分享信息,感到更满意、更受尊重、更信任他们的提供者的意见。与解雇情景相比,解释情景被认为没有什么不同。结论:超过三分之一的受访者表示,在与医疗服务提供者分享患者身份信息时,存在负面沟通。提供者优先考虑的关系建设和解释可以促进信任和促进公开的信息交流,支持明智的决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.40
自引率
7.50%
发文量
518
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