Perceived doctor‐patient relationship and its association with demoralization in patients with advanced cancer

TY - JOUR

T1 - Perceived doctor‐patient relationship and its association with demoralization in patients with advanced cancer

AU - Quintero Garzón, Leonhard

AU - Koranyi, Susan

AU - Engelmann, Dorit

AU - Philipp, Rebecca

AU - Scheffold, Katharina

AU - Schulz-Kindermann, Frank

AU - Härter, Martin

AU - Mehnert, Anja

PY - 2018

Y1 - 2018

N2 - Background: Advanced diseases pose a great burden on patients and go hand in hand with existential concerns. Demoralization is considered as a syndrome of existential distress with a perceived inability to cope with loss of meaning in life and feelings of helplessness and hopelessness. Professional health care providers play an important role in providing support for patients and unfavorable conversational styles in their relationship can increase patient's distress. In this study, we examine the association between the patient's perceived relationship to health care providers and demoralization. Methods: We used baseline data of a randomized control trial intervention study for advanced cancer patients (UICC‐Stage ≥ III; PHQ ≥ 9 and/or Distress‐Thermometer ≥5). We used a subscale of the QUAL‐EC‐P for assessing doctor‐patient relationship, Beck Depression Inventory‐II for depressive symptoms, a modified version of the MSAS as physiological symptom checklist, and the Demoralization Scale to assess demoralization. A hierarchical regression analysis was calculated. Results: In our sample of 187 patients with stage III or IV cancer (62% women), demoralization was present in 53.4% (16% moderate demoralization; 37.4% high demoralization) of the patients. Relationship to health care provider was an independent predictor (β = −.33, t(186) = −6.70, P < .001) of demoralization. Conclusions: Our findings underline the importance of the physician‐patient relationship in the context of coping with existential challenges in advanced cancer patients. Trainings on how to communicate and build a sustainable relationship with patients and their specific needs may increase the buffering effect of social support by the physicians on patient's existential distress.

AB - Background: Advanced diseases pose a great burden on patients and go hand in hand with existential concerns. Demoralization is considered as a syndrome of existential distress with a perceived inability to cope with loss of meaning in life and feelings of helplessness and hopelessness. Professional health care providers play an important role in providing support for patients and unfavorable conversational styles in their relationship can increase patient's distress. In this study, we examine the association between the patient's perceived relationship to health care providers and demoralization. Methods: We used baseline data of a randomized control trial intervention study for advanced cancer patients (UICC‐Stage ≥ III; PHQ ≥ 9 and/or Distress‐Thermometer ≥5). We used a subscale of the QUAL‐EC‐P for assessing doctor‐patient relationship, Beck Depression Inventory‐II for depressive symptoms, a modified version of the MSAS as physiological symptom checklist, and the Demoralization Scale to assess demoralization. A hierarchical regression analysis was calculated. Results: In our sample of 187 patients with stage III or IV cancer (62% women), demoralization was present in 53.4% (16% moderate demoralization; 37.4% high demoralization) of the patients. Relationship to health care provider was an independent predictor (β = −.33, t(186) = −6.70, P < .001) of demoralization. Conclusions: Our findings underline the importance of the physician‐patient relationship in the context of coping with existential challenges in advanced cancer patients. Trainings on how to communicate and build a sustainable relationship with patients and their specific needs may increase the buffering effect of social support by the physicians on patient's existential distress.

M3 - SCORING: Journal article

VL - 27

SP - 2587

EP - 2593

JO - PSYCHO-ONCOLOGY

JF - PSYCHO-ONCOLOGY

SN - 1057-9249

IS - 11

ER -