title: Patient-physician communication and health-related quality of life of patients with localised prostate cancer undergoing radical prostatectomy - a longitudinal multilevel analysis.
abstract: To examine whether patient-physician communication is associated with health-related quality of life (HRQoL) in a sample of patients with localised prostate cancer undergoing radical prostatectomy (RP).
  
  
  
  HAROW (Hormonal therapy, Active Surveillance, Radiation, Operation, Watchful Waiting) is a prospective, observational study designed to collect data of the different treatment options for newly diagnosed patients with localised prostate cancer under real-life conditions. At 6-months intervals, clinical data (D'Amico risk categories, Charlson comorbidity index), aspects of patient-provider communication (standardised psychosocial-care instrument for patients' assessment of communication; Cologne Patient Questionnaire), and HRQoL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) were assessed. Data were analysed by longitudinal multilevel analysis.
  
  
  
  Completed questionnaires for 1772 patients undergoing a RP were analysed over a 3-year follow-up period. Patients rated the patient-provider communication generally high with slight variations over the course of treatment (3.2-3.8). The HRQoL of the patients varied substantial over time and between the reported subscales (global HRQoL 71.1-77.2; physical functioning 89.1-92.1; role functioning 81.0-88.1; emotional functioning 74.4-84.0; cognitive functioning 84.3-87.7; social functioning (77.7-84.0). The longitudinal multilevel models showed significant associations between patient-provider communication in terms of devotion, support and shared decision-making, and functional aspects of HRQoL.
  
  
  
  Patient-provider communication is a valuable resource to support patients with prostate cancer coping with the disease and to improve their HRQoL. Future interventions should be designed especially for urologists to enhance their awareness for the importance of communication and the relationship with their patients with prostate cancer for treatment outcomes.
authors.affiliation: Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Germany, Bonn.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ernstmann
authors.affiliation: Stiftung Maennergesundheit, Berlin, Germany.
authors.forename: Lothar
authors.initials: L
authors.lastname: Weissbach
authors.affiliation: Department of Urology, University Hospital of Cologne, Cologne, Germany.
authors.forename: Jan
authors.identifier: 0000-0002-1667-5200
authors.initials: J
authors.lastname: Herden
authors.affiliation: Department of Urology, University Hospital of Cologne, Cologne, Germany.
authors.forename: Nicola
authors.initials: N
authors.lastname: Winter
authors.affiliation: Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Ansmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life
keywords: communication; health-related quality of life; localised prostate cancer; prostatectomy; psychosocial needs