Patient-centered communication and psychological well-being among patients with chronic medical conditions.

Abstract

Background: Chronic medical conditions (CCs) are the leading causes of morbidity and mortality in the U.S. Patients with CCs often experience anxiety, depression, and other mental or emotional health problems. Although patient-centered communication (PCC) practice may address mental health needs through opportunities for emotional expression, reassurance, and support, there is limited evidence on the effects of PCC on the psychological well-being of patients with CCs.

Methods: Pooled cross-sectional data were extracted from the U.S. National Cancer Institute's Health Information National Trends Survey (HINTS5; Cycles 1-4; 2017-2020) for 9,199 respondents (≥18 years, reported ≥1 CC, non-Hispanic White = 65.7%). PCC was measured on a composite score scale (0-100). Psychological distress (anxiety and depression) was assessed using the Patient Health Questionnaire-4 (PHQ-4). We performed multivariable logistic regressions to investigate associations between PCC and psychological distress.

Results: Nearly 20.4% of the patients experienced clinically significant anxiety, and 18.0% experienced depressive symptoms. With each additional unit increase on the PCC score scale, the odds of experiencing anxiety (aOR = 0.992; 95% CI: 0.986, 0.998) and depression (aOR = 0.989; 95% CI: 0.984, 0.995) decreased by approximately 1%.

Conclusions: Our findings revealed that enhanced PCC is associated with reduced odds of anxiety and depression among patients with CCs. Integrating holistic care models will be crucial to addressing the complex needs of patients with CCs. Policymakers and healthcare providers could expand training programs to strengthen PCC skills and potentially enhance the mental well-being of patients with chronic medical conditions.

Plain language abstract: This study examines the potential impacts of patient-centered communication (PCC) on mental health among patients with chronic disease. Analyzing data obtained from a U.S. national survey, the findings demonstrate that improved PCC is associated with lower levels of anxiety and depression. This suggests that healthcare providers' active engagement and more effective communication with patients can potentially improve their mental health and well-being. The findings highlight the importance of training healthcare providers in PCC practice to enhance the overall care and mental health of patients with chronic disease. Additionally, this research advocates implementing patient-centered, holistic care models to address both the physical and mental health needs of patients with chronic disease.