1. Treatment Summaries and Follow-Up Care Instructions for Cancer Survivors: Improving Survivor Self-Efficacy and Health Care Utilization.
- Author
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Kenzik, Kelly M., Kvale, Elizabeth A., Rocque, Gabrielle B., Demark‐Wahnefried, Wendy, Martin, Michelle Y., Jackson, Bradford E., Meneses, Karen, Partridge, Edward E., and Pisu, Maria
- Subjects
CHRONIC disease treatment ,GERIATRIC assessment ,ANALYSIS of covariance ,CANCER patients ,CANCER patient medical care ,CANCER treatment ,CONFIDENCE intervals ,HOSPITAL care ,PATIENT aftercare ,HOSPITAL emergency services ,MEDICAL care use ,MEDICAL protocols ,MULTIHOSPITAL systems ,PATH analysis (Statistics) ,RESEARCH funding ,SCALE analysis (Psychology) ,SELF-efficacy ,STATISTICS ,SURVEYS ,TUMOR classification ,DISEASE management ,COMORBIDITY ,DATA analysis ,MULTIPLE regression analysis ,QUANTITATIVE research ,SOCIOECONOMIC factors ,SPECIALTY hospitals ,PATIENT discharge instructions ,HEALTH literacy ,DESCRIPTIVE statistics - Abstract
Background. Treatment summaries and follow-up care plan information should be provided to cancer survivors. This study examines the association of receiving summaries and care plans with cancer survivor self-efficacy for chronic illness management, and whether self-efficacy was associated with health care utilization. Methods. Four hundred forty-one cancer survivors (≥2 years from diagnosis and had completed treatment) ≥65 years old from 12 cancer centers across 5 states completed telephone surveys. Survivors responded to three questions about receiving a written treatment summary, written follow-up plan, and an explanation of follow-up care plans. Respondents completed the Stanford Chronic Illness Management Self-Efficacy Scale and reported emergency room visits and hospitalizations in the past year. Three multiple linear regression models estimated the association of written treatment summary, written follow-up care plan, and verbal explanation of follow-up plan with total self-efficacy score. Log-binomial models estimated the association of self-efficacy scores with emergency room visits and hospitalizations (yes/no). Results. Among survivors, 40% and 35% received a written treatment summary and follow-up care plan, respectively. Seventy-nine percent received an explanation of follow-up care plans. Receiving a verbal explanation of follow-up care instructions was significantly associated with higher self-efficacy scores (β = 0.72, p = .009). Higher self-efficacy scores were significantly associated with lower prevalence ratios of emergency room visits (prevalence ratio, 0.92; 95% confidence interval, 0.88-0.97) and hospitalizations (prevalence ratio, 0.94; 95% confidence interval, 0.89-0.99). Conclusion. Explanation of the follow-up care plan, beyond the written component, enhances survivor self-efficacy for managing cancer as a chronic condition--an important mediator for improving health care utilization outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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