Pd32-04 clinical and decision-making factors impacting patient-centered communication in patients with clinical t1 renal masses

You have accessJournal of UrologyCME1 Apr 2023PD32-04 CLINICAL AND DECISION-MAKING FACTORS IMPACTING PATIENT-CENTERED COMMUNICATION IN PATIENTS WITH CLINICAL T1 RENAL MASSES Kathryn Gessner, Amir Feinberg, Shannon Myers, Hillary Heiling, Allison Deal, Sara Wobker, Allison Lazard, Marc Bjurlin, Mathew Raynor, Matthew Nielsen, Angela Smith, Eric Wallen, David Johnson, William Kim, and Hung-Jui Tan Kathryn GessnerKathryn Gessner More articles by this author , Amir FeinbergAmir Feinberg More articles by this author , Shannon MyersShannon Myers More articles by this author , Hillary HeilingHillary Heiling More articles by this author , Allison DealAllison Deal More articles by this author , Sara WobkerSara Wobker More articles by this author , Allison LazardAllison Lazard More articles by this author , Marc BjurlinMarc Bjurlin More articles by this author , Mathew RaynorMathew Raynor More articles by this author , Matthew NielsenMatthew Nielsen More articles by this author , Angela SmithAngela Smith More articles by this author , Eric WallenEric Wallen More articles by this author , David JohnsonDavid Johnson More articles by this author , William KimWilliam Kim More articles by this author , and Hung-Jui TanHung-Jui Tan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003325.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Management of clinical T1 renal masses has become a complex, preference-sensitive decision. In a previous study, 30% of patients with SRMs reported decisional conflict. More patient-centered communication that could reduce decisional conflict, but its determinants remain unknown. Therefore, we sought to evaluate the clinical and decision-making factors impacting patient-centered communication in patients with clinical T1 renal masses. METHODS: From October 2018–June 2022, we enrolled patients with new clinical T1 kidney tumors onto GRADE-SRM, a comparative, non-randomized hybrid trial investigating the decision-making experience and cancer genomics. Upon study entry (T0) and 2-4 weeks later (T1), participants completed surveys to characterize their decision-making and communication preferences in addition to demographic, health, and tumor characteristics. Patient-centered communication served as the primary outcome and measured by the validated Patient-Centered Communication in Cancer Care (PCC) Instrument. We examined the relationship between PCC and patient/tumor characteristics through repeated measures bivariable linear regression analyses using generalized estimating equations. RESULTS: Among 265 enrollees, 229 completed a T0 PCC survey and 195 enrollees completed a T1PCC survey. Mean age was 62.3 years (SD 11.2), 61.4% were male, and 31.8% were non-White. Overall, mean PCC score was 4.40 (SD 0.62) at T0 and 4.31 (SD 0.69) at T1. Patients with higher levels of education (p=0.047), previous history of kidney cancer (p=0.0001), and previous abdominal surgery (p=0.011) reported better communication scores. Worse communication scores were associated with seeing an outside urologist prior to UNC evaluation (p=0.022) and higher perceived risk of metastasis (p=0.015). Better communication scores were associated with higher self-efficacy (p=0.003), numeracy (p=0.019) and information seeking behavior (p=0.011), while worse communication scores were associated with increased worry (p=0.021). CONCLUSIONS: For patients with SRMs, more patient-centered communication is reported by those with similar past healthcare experiences, more self-efficacy, and information seeking behavior. These findings highlight the importance of both lived experiences and patient learning ability on their perception of communication. Efforts to improve communication and decision-making may need to be directed toward these action points. Source of Funding: This work was supported by funding from the National Institutes of Health (UNC Integrated Translational Oncology Program T32-CA244125 to UNC/khg) and UNC Lineberger Comprehensive Cancer Center UNCseq v2 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e908 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kathryn Gessner More articles by this author Amir Feinberg More articles by this author Shannon Myers More articles by this author Hillary Heiling More articles by this author Allison Deal More articles by this author Sara Wobker More articles by this author Allison Lazard More articles by this author Marc Bjurlin More articles by this author Mathew Raynor More articles by this author Matthew Nielsen More articles by this author Angela Smith More articles by this author Eric Wallen More articles by this author David Johnson More articles by this author William Kim More articles by this author Hung-Jui Tan More articles by this author Expand All Advertisement PDF downloadLoading ...