April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Predicting Disclosure: The Role of Support People in Prostate Cancer Patient-Oncologist Communication
Background: Higher patient engagement during healthcare interactions is related to better outcomes such as increased positive coping, improved quality of life and psychological well-being, and better health management. Moreover, decisions such as what information is communicated with or withheld from a provider are critical in oncology, where patients are involved in treatment planning and are psychologically adjusting to their diagnosis.
Cancer patients often turn to their social support network (e.g., spouses, family members, and close friends) to help manage their diagnosis and related symptoms. Support people’s presence in cancer care appointments can affect patient-oncologist communication. For example, ovarian cancer patients report that some information (e.g., treatment-related) is easier to share with their oncologist when their support person is present, while other information (e.g., concerns about future) is more difficult. However, little is known about which specific processes are affected by a support person’s presence. Informed by the disclosure decision-making model, this study investigated how communication behaviors of support people facilitate or inhibit cancer patients’ efficacy for disclosure and subsequent disclosure of health information to their oncologist.
Methods: Prostate cancer patients (N = 64 men, enrollment ongoing) were recruited through the [anonymized] Cancer Institute to complete an online questionnaire about perceptions of their support persons’ helpful (e.g., paying attention during appointments) and unhelpful (e.g., talking over the patient) behaviors, their disclosure efficacy, their sharing of health information with their oncologist, and their withholding of health-related information.
Results: Regressions revealed that helpful support person behaviors predicted prostate cancer patients’ disclosure efficacy such that more helpful behaviors were associated with more efficacy (β=0.31; p<0.01) when controlling for unhelpful behaviors. Similarly, unhelpful support person behaviors predicted patients’ disclosure efficacy such that more unhelpful behaviors were associated with less efficacy (β=-0.19; p=0.04), controlling for helpful behaviors. Patients’ disclosure efficacy predicted more sharing of health information (β=0.49; p<0.01) and less withholding of information (β=-0.77; p<0.01) from their oncologist.
Analyses also revealed that helpful support person behaviors predicted patients’ sharing of health information with their oncologist when controlling for disclosure and unhelpful support person behaviors (β=0.34; p=0.04). However, disclosure efficacy (β=0.35; p=0.07) and unhelpful behaviors (β=0.02; p=0.07) did not predict sharing of health information when controlling for helpful behaviors. Contrasting the predictors of sharing with the oncologist, withholding of health information was predicted by disclosure efficacy (β=-0.51; p<0.01) and unhelpful behaviors (β=0.45; p<0.01) when controlling for helpful behaviors. Withholding of health information was not predicted by helpful support person behaviors when controlling for disclosure efficacy and unhelpful behaviors (β=-0.18; p=0.19).
Discussion: Overall, helpful support person behaviors positively affected patients’ disclosure efficacy and subsequent disclosure decisions. Moreover, the negative effects of unhelpful behaviors did not affect efficacy or disclosure when controlling for helpful behaviors. Results from this study reinforce previous research on the effect of bolstering (or hindering) cancer patients’ disclosure efficacy on subsequent decisions regarding what is shared and withheld from cancer providers. These results are promising for developing interventions for both patients and support people in the cancer context.
Cancer patients often turn to their social support network (e.g., spouses, family members, and close friends) to help manage their diagnosis and related symptoms. Support people’s presence in cancer care appointments can affect patient-oncologist communication. For example, ovarian cancer patients report that some information (e.g., treatment-related) is easier to share with their oncologist when their support person is present, while other information (e.g., concerns about future) is more difficult. However, little is known about which specific processes are affected by a support person’s presence. Informed by the disclosure decision-making model, this study investigated how communication behaviors of support people facilitate or inhibit cancer patients’ efficacy for disclosure and subsequent disclosure of health information to their oncologist.
Methods: Prostate cancer patients (N = 64 men, enrollment ongoing) were recruited through the [anonymized] Cancer Institute to complete an online questionnaire about perceptions of their support persons’ helpful (e.g., paying attention during appointments) and unhelpful (e.g., talking over the patient) behaviors, their disclosure efficacy, their sharing of health information with their oncologist, and their withholding of health-related information.
Results: Regressions revealed that helpful support person behaviors predicted prostate cancer patients’ disclosure efficacy such that more helpful behaviors were associated with more efficacy (β=0.31; p<0.01) when controlling for unhelpful behaviors. Similarly, unhelpful support person behaviors predicted patients’ disclosure efficacy such that more unhelpful behaviors were associated with less efficacy (β=-0.19; p=0.04), controlling for helpful behaviors. Patients’ disclosure efficacy predicted more sharing of health information (β=0.49; p<0.01) and less withholding of information (β=-0.77; p<0.01) from their oncologist.
Analyses also revealed that helpful support person behaviors predicted patients’ sharing of health information with their oncologist when controlling for disclosure and unhelpful support person behaviors (β=0.34; p=0.04). However, disclosure efficacy (β=0.35; p=0.07) and unhelpful behaviors (β=0.02; p=0.07) did not predict sharing of health information when controlling for helpful behaviors. Contrasting the predictors of sharing with the oncologist, withholding of health information was predicted by disclosure efficacy (β=-0.51; p<0.01) and unhelpful behaviors (β=0.45; p<0.01) when controlling for helpful behaviors. Withholding of health information was not predicted by helpful support person behaviors when controlling for disclosure efficacy and unhelpful behaviors (β=-0.18; p=0.19).
Discussion: Overall, helpful support person behaviors positively affected patients’ disclosure efficacy and subsequent disclosure decisions. Moreover, the negative effects of unhelpful behaviors did not affect efficacy or disclosure when controlling for helpful behaviors. Results from this study reinforce previous research on the effect of bolstering (or hindering) cancer patients’ disclosure efficacy on subsequent decisions regarding what is shared and withheld from cancer providers. These results are promising for developing interventions for both patients and support people in the cancer context.