The association among cancer patients' collaboration with their healthcare providers, self-management and well-being during radiotherapy: An observational, cross-sectional survey.

2020 
OBJECTIVES Patients adapt to cancer through self-management, which requires collaboration between patients and their healthcare providers. We aimed to describe patterns of patient-provider collaboration during radiotherapy and examine associations among patient-provider collaboration, self-management and well-being. METHODS An observational, cross-sectional study was conducted at a cancer centre in the province of Ontario, Canada. Cancer patients (N = 130) completed a one-time questionnaire during their radiotherapy. The questionnaire assessed three variables: collaboration with healthcare providers, self-management and well-being. Patterns of collaboration were analysed using descriptive statistics. Associations among study variables were assessed through structural equation modelling (SEM). Separate models were tested for patient-nurse and patient-oncologist collaboration. RESULTS Participants reported greater collaboration with oncologists than with nurses or radiation therapists. Most participants reported no collaboration with other providers within healthcare teams (e.g. social workers, dietitians). SEM revealed different patterns for the patient-nurse and patient-oncologist collaboration models, where collaboration predicted one self-management aspect, and both physical and mental well-being. CONCLUSION During radiotherapy, patients collaborated mainly with doctors, nurses and radiation therapists. Collaborative relationships between patients and providers may enhance patient outcomes by fostering their self-management skills. Initiatives to strengthen patient-provider relationships and support self-management should be developed and applied to interprofessional-cancer-care teams. IMPACT This is the first known study to empirically support the links among patient-provider collaboration, self-management and patient outcomes. The study results can enhance practice, research and education.
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