Health literacy and patient participation in multidisciplinary tumor conferences in breast cancer care: a multilevel modeling approach. View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Christian Heuser, Annika Diekmann, Christoph Kowalski, Anna Enders, Rupert Conrad, Holger Pfaff, Lena Ansmann, Nicole Ernstmann

ABSTRACT

BACKGROUND: Decisions made in multidisciplinary tumor conferences (MTC) that consider patient preferences result in better patient outcomes. Furthermore, it has been shown that in some breast cancer centers in Germany, patients participate in MTCs and that participation is associated with sociodemographic and breast cancer center-related factors. Health literacy (HL) has been shown to be predictive for individual health behavior and is an important prerequisite for patient participation in healthcare. However, so far nothing is known about the association between HL and MTC patient participation. To close this gap in research, we analyzed which patient characteristics affect participation in MTCs and whether participation varies between breast cancer centers. METHODS: In a prospective, multicenter cohort study, newly diagnosed breast cancer patients were surveyed directly after surgery (T1) as well as 10 weeks (T2) and 40 weeks (T3) after surgery. After descriptive analysis, t-tests were conducted, correlations for independent variables were run, and logistic multilevel regression analysis was applied to estimate the association between patient participation in MTCs at T1 and HL (HLS-EU-Q16 [1]), sociodemographic and disease-related characteristics (n = 863 patients) and the variation between breast cancer centers (n = 43 centers). RESULTS: Descriptive results show that 6.8% of breast cancer patients took part in a MTC. The logistic multilevel regression model revealed that patients with an inadequately HL are less likely to participate in MTCs (OR = 0.31, 95%-CI = 0.1-0.9, Pseudo-R2 = 0.06), and participation is dependent on the breast cancer center (ICC = 0.161). CONCLUSIONS: These findings are the first to show significant differences in HL and patient participation in MTCs in a large sample of breast cancer patients. In future research on patient participation in MTCs and HL, questions concerning the organization, communication and decision-making in MTCs with and without patient participation have to be addressed, and patient and provider perspectives must be equally considered. TRIAL REGISTRATION: Database Health Services Research, VfD_PIAT_12_001630 , registered prospectively on 01.03.2012. More... »

PAGES

330

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12885-019-5546-z

DOI

http://dx.doi.org/10.1186/s12885-019-5546-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113300218

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30961598


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    "description": "BACKGROUND: Decisions made in multidisciplinary tumor conferences (MTC) that consider patient preferences result in better patient outcomes. Furthermore, it has been shown that in some breast cancer centers in Germany, patients participate in MTCs and that participation is associated with sociodemographic and breast cancer center-related factors. Health literacy (HL) has been shown to be predictive for individual health behavior and is an important prerequisite for patient participation in healthcare. However, so far nothing is known about the association between HL and MTC patient participation. To close this gap in research, we analyzed which patient characteristics affect participation in MTCs and whether participation varies between breast cancer centers.\nMETHODS: In a prospective, multicenter cohort study, newly diagnosed breast cancer patients were surveyed directly after surgery (T1) as well as 10\u2009weeks (T2) and 40\u2009weeks (T3) after surgery. After descriptive analysis, t-tests were conducted, correlations for independent variables were run, and logistic multilevel regression analysis was applied to estimate the association between patient participation in MTCs at T1 and HL (HLS-EU-Q16 [1]), sociodemographic and disease-related characteristics (n\u00a0=\u2009863 patients) and the variation between breast cancer centers (n\u00a0=\u200943 centers).\nRESULTS: Descriptive results show that 6.8% of breast cancer patients took part in a MTC. The logistic multilevel regression model revealed that patients with an inadequately HL are less likely to participate in MTCs (OR\u2009=\u20090.31, 95%-CI\u2009=\u20090.1-0.9, Pseudo-R2\u00a0=\u20090.06), and participation is dependent on the breast cancer center (ICC\u2009=\u20090.161).\nCONCLUSIONS: These findings are the first to show significant differences in HL and patient participation in MTCs in a large sample of breast cancer patients. In future research on patient participation in MTCs and HL, questions concerning the organization, communication and decision-making in MTCs with and without patient participation have to be addressed, and patient and provider perspectives must be equally considered.\nTRIAL REGISTRATION: Database Health Services Research, VfD_PIAT_12_001630 , registered prospectively on 01.03.2012.", 
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