Adolescent cancer patients' perceived quality of cancer care: The roles of patient engagement and supporting independence

Patient Educ Couns. 2018 Sep;101(9):1683-1689. doi: 10.1016/j.pec.2018.04.002. Epub 2018 Apr 10.

Abstract

Objectives: A lack of focus on variation in engagement among cancer populations of differing developmental stages led us to examine the associations between patient engagement, the patient-provider relationship, cognitive development, readiness to transition to adulthood (transitional readiness) and perceived quality of care.

Methods: A sample of 101 adolescent cancer patients (diagnosed 10-20 years) completed survey items concerning patient engagement, dimensions of the patient-provider relationship, cognitive development, transitional readiness, and demographic characteristics using an iPad/tablet during a routine clinic visit.

Results: Patient engagement was not significantly associated with perceived quality of care (b = .02, 95% CI: -0.06, 0.11). Instead, adolescents with providers that supported their independence (b = .34, 95% CI: 0.17, 0.52) were significantly more likely to perceive higher quality care.

Conclusion: Supportive patient-provider relationships are an integral part of adolescents' perceptions of quality of care. Adolescents are still gaining important skills for navigating the medical system, and the patient-provider relationship may provide an important scaffolding relationship to help adolescents build independence in their treatment experience.

Practice implications: Identifying potential mechanisms through which adolescents can provide their opinion, ask questions, and participate in their treatment plan will help in supporting adolescent independence and improve quality of care.

Keywords: Adolescent cancer; Patient engagement; Patient-provider relationship; Quality of care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Patient Care Planning
  • Patient Participation*
  • Perception
  • Physician-Patient Relations*
  • Quality of Health Care*
  • Transition to Adult Care