Engagement in Care among Patients with Lung Cancer




Thomas, Anna Johnson

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BACKGROUND: Engagement in care broadly refers to patients' knowledge, skills, ability and willingness to play an active role in their health. Patient activation is a core component of engagement and has been associated with better care outcomes in several chronic health populations. Despite these findings, patient activation has been understudied in oncology populations broadly, with little focus on lung cancer patients specifically. OBJECTIVE: The primary aim of this study was to describe patient activation among surveyed lung cancer patients. A second aim was to explore specific demographic, smoking-related, and psychosocial correlates of patient activation. METHOD: The sample included 231 lung patients who participated in a cross-sectional, multisite study. Patients completed a patient activation self-report instrument, along with demographic, clinical, and psychosocial measures. ANALYSIS: Data related to study aims were analyzed using univariate and multivariable analysis. RESULTS: Among lung cancer patients, overall patient activation scores were significantly lower for current smokers compared to former and never smokers (F (2, 218) = 4.50, p = 0.01), for men when compared with women (F (1, 220) = 8.75, p < 0.01), and for those who reported clinically significant depressive symptoms when compared with those who did not (F (1, 219) = 13.95, p < 0.001). In multivariable analysis, these significant main effects of smoking status, gender, and depressive symptoms remained. DISCUSSION: Among lung cancer patients, those who were current smokers, were male, and those who endorsed high depressive symptomatology were likely to have the lowest activation scores in the sample. Practical recommendations include clinically identifying these high-risk patients through assessment and addressing activation via evidence based intervention.

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