April 22-24, 2021
Promoting Equity in Health Communication Research
Promoting Equity in Health Communication Research
Abstract: Communication about Covid-19 during patients’ telemedicine visits with their oncologists
Introduction
The COVID-19 pandemic has led to changes in healthcare delivery and access. One change is the recent shift toward increased utilization of telemedicine. As clinician-patient communication impacts health outcomes, investigation of user experiences and effects on communication amid the pandemic is needed. Because individuals with cancer and those receiving cancer treatment are often immunocompromised, this may lead to questions and concerns about COVID-19 risk and talking with their clinician via telemedicine. The aim of this study was to determine the degree to which patients with cancer discussed COVID-19 with their clinicians via telemedicine in the early months of the pandemic.
Methods
We disseminated an online survey to participants from a large medical university recruited through a Contact Registry, as well as national organizations for outside recruitment between July and October 2020. The survey included questions about socio-demographics, cancer diagnosis, and telemedicine use since March 2020. Frequency statistics described the sample and chi-squared analyses were used to understand relationships between variables.
Results
Data was collected from 170 participants. Participants were, on average, 64.21 (SD = 12.98) years old. About half of the participants (n = 84; 49.4%) were female, whereas the majority were non-Hispanic (n = 136; 80%) and white (n = 133; 78.2%) with at least some college experience (n = 158; 92.9%). Waldenstrom's Macroglobulinemia (n = 56; 32.9%) and breast cancer (n = 20; 11.8%) were the most common cancer diagnoses. Participants reported seeing their oncology team via telemedicine a median of one time, which typically included medical oncologists (n = 110; 64.7%). Most participants (n = 136; 80%) reported having discussed COVID-19 with their oncologist, which included the pandemic in general (n = 69; 40.6%) and their specific COVID-19 risk (n = 70; 41.2%) more so than coping mechanisms (n = 44; 25.9%) and effects on treatment plan (n = 33; 19.4%). Participants reported spending on average approximately 5.13 minutes discussing COVID-19 in their last visit (SD = 4.54; min = 1; max = 40). Participants who talked with their oncologist about COVID-19 at their last appointment were more likely to have met with their clinician in-person prior [X2 (1, N = 156) = 4.84, p < .05]. By the time of the conference, we will have also collected and analyzed data from qualitative interviews with clinicians and patients about their experiences to complement this quantitative analysis.
Discussion
Most patients with cancer talked with their clinician about COVID-19 during a telemedicine appointment, and the topics of risk and the pandemic in general were primary concerns. Recalled durations of the conversations varied considerably. Prior relationship with a clinician appeared to be an influential factor in discussing COVID-19 during the telemedicine visit. Future research is needed to further investigate this clinician-patient relationship dynamic and its impact on patient communication. The present study helps in understanding the extent to which the current global health crisis occupies the minds of patients and the time clinicians may spend in practice addressing questions and concerns pertaining to COVID-19.
The COVID-19 pandemic has led to changes in healthcare delivery and access. One change is the recent shift toward increased utilization of telemedicine. As clinician-patient communication impacts health outcomes, investigation of user experiences and effects on communication amid the pandemic is needed. Because individuals with cancer and those receiving cancer treatment are often immunocompromised, this may lead to questions and concerns about COVID-19 risk and talking with their clinician via telemedicine. The aim of this study was to determine the degree to which patients with cancer discussed COVID-19 with their clinicians via telemedicine in the early months of the pandemic.
Methods
We disseminated an online survey to participants from a large medical university recruited through a Contact Registry, as well as national organizations for outside recruitment between July and October 2020. The survey included questions about socio-demographics, cancer diagnosis, and telemedicine use since March 2020. Frequency statistics described the sample and chi-squared analyses were used to understand relationships between variables.
Results
Data was collected from 170 participants. Participants were, on average, 64.21 (SD = 12.98) years old. About half of the participants (n = 84; 49.4%) were female, whereas the majority were non-Hispanic (n = 136; 80%) and white (n = 133; 78.2%) with at least some college experience (n = 158; 92.9%). Waldenstrom's Macroglobulinemia (n = 56; 32.9%) and breast cancer (n = 20; 11.8%) were the most common cancer diagnoses. Participants reported seeing their oncology team via telemedicine a median of one time, which typically included medical oncologists (n = 110; 64.7%). Most participants (n = 136; 80%) reported having discussed COVID-19 with their oncologist, which included the pandemic in general (n = 69; 40.6%) and their specific COVID-19 risk (n = 70; 41.2%) more so than coping mechanisms (n = 44; 25.9%) and effects on treatment plan (n = 33; 19.4%). Participants reported spending on average approximately 5.13 minutes discussing COVID-19 in their last visit (SD = 4.54; min = 1; max = 40). Participants who talked with their oncologist about COVID-19 at their last appointment were more likely to have met with their clinician in-person prior [X2 (1, N = 156) = 4.84, p < .05]. By the time of the conference, we will have also collected and analyzed data from qualitative interviews with clinicians and patients about their experiences to complement this quantitative analysis.
Discussion
Most patients with cancer talked with their clinician about COVID-19 during a telemedicine appointment, and the topics of risk and the pandemic in general were primary concerns. Recalled durations of the conversations varied considerably. Prior relationship with a clinician appeared to be an influential factor in discussing COVID-19 during the telemedicine visit. Future research is needed to further investigate this clinician-patient relationship dynamic and its impact on patient communication. The present study helps in understanding the extent to which the current global health crisis occupies the minds of patients and the time clinicians may spend in practice addressing questions and concerns pertaining to COVID-19.