Cancer survivors' disclosure of complementary health approaches to physicians: The role of patient‐centered communication

• Published in: Cancer 2015-03, Vol.121 (6), p.900-907
• Main Authors: Sohl, Stephanie J., Borowski, Laurel A., Kent, Erin E., Smith, Ashley Wilder, Oakley‐Girvan, Ingrid, Rothman, Russell L., Arora, Neeraj K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Colorectal Neoplasms - psychology; Colorectal Neoplasms - therapy; Communication; complementary medicine; complementary therapies; Complementary Therapies - psychology; Complementary Therapies - utilization; Cross-Sectional Studies; Data Collection; Female; Humans; Leukemia - psychology; Leukemia - therapy; Male; Middle Aged; neoplasms; Neoplasms - psychology; Neoplasms - therapy; patient‐centered care; Physician-Patient Relations; Physicians; Self Disclosure; Surveys and Questionnaires; survivors; Survivors - psychology; Urinary Bladder Neoplasms - psychology; Urinary Bladder Neoplasms - therapy; Young Adult
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.29138

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. Cancer 2015;121:900–907. © 2014 American Cancer Society. Analyses of a population‐based sample of cancer survivors support the idea that improving the overall patient centeredness of cancer follow‐up care and improving the disclosure of complementary health approaches to physicians are potentially synergistic clinical goals.