Cancer survivors' disclosure of complementary health approaches to physicians: the role of patient-centered communication.
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.
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Stephanie J
SJ
Sohl
Laurel A
LA
Borowski
Erin E
EE
Kent
Ashley Wilder
AW
Smith
Ingrid
I
Oakley-Girvan
Russell L
RL
Rothman
Neeraj K
NK
Arora
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000523:psychology / Q000628:therapy; D003142:Communication; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D007938:Leukemia / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010817:Physician-Patient Relations; D010820:Physicians; D012650:Self Disclosure; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D001749:Urinary Bladder Neoplasms / Q000523:psychology / Q000628:therapy; D055815:Young Adult
communication; complementary medicine; complementary therapies; neoplasms; patient-centered care; survivors