Journal of Cancer Survivorship

, Volume 13, Issue 5, pp 663–672 | Cite as

Implications for patient-provider communication and health self-efficacy among cancer survivors with multiple chronic conditions: results from the Health Information National Trends Survey

  • Jessica D. AustinEmail author
  • Michael C. Robertson
  • L. Aubree Shay
  • Bijal A. Balasubramanian



Cancer survivors with multiple chronic conditions experience significant challenges managing their health. The six core functions of patient-centered communication (PCC)—fostering healing relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient self-management—represent a central component to facilitating a survivor’s confidence to manage their health that has not been investigated in cancer survivors with multiple chronic conditions.


Nationally representative data across two iterations of the Health Information National Trends Survey (HINTS) were merged with combined replicate weights using the jackknife replication method. Adjusted linear regression examined the association between PCC and health self-efficacy in a sample of breast, colorectal, and prostate cancer survivors and by multiple chronic conditions.


53.9% reported that providers did not always respond to their emotions and 48.9% reported that they could not always rely on their providers to help them manage uncertainty. In the adjusted linear regression models, there was a significant positive association between PCC and health self-efficacy (β = 0.2, p = 0.01) for the entire sample. However, the association between PCC and health self-efficacy was attenuated in cancer survivors with multiple chronic conditions (β = 0.1, p = 0.53).


PCC alone is not enough to improve a cancer survivor’s confidence in their ability to manage their health in the presence of multiple chronic conditions.

Implications for Cancer Survivors

Cancer survivors with multiple chronic conditions need ongoing support, in addition to PCC, that render them prepared to manage their health after cancer.


Cancer survivorship Multiple chronic conditions Patient-provider communication Self-efficacy 



This research was made possible by the UTHealth School of Public Health Cancer Education and Career Development Program, the Center for Energy Balance in Cancer Prevention and Survivorship, and the Duncan Family Institute for Cancer Prevention and Risk Assessment.


This study was financially supported by the UTHealth School of Public Health Cancer Education and Career Development Program (NCI Grant T32 CA057712) and by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant (NCI Grant P30 CA016672).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Health Promotion Behavioral ScienceUTHealth School of Public Health in DallasDallasUSA
  2. 2.Center for Energy Balance, Department of Behavioral ScienceMD Anderson Cancer CenterHoustonUSA
  3. 3.Department of Health Promotion & Behavioral SciencesUTHealth School of Public Health in HoustonHoustonUSA
  4. 4.Department of Health Promotion Behavioral ScienceUTHealth School of Public Health in San AntonioSan AntonioUSA
  5. 5.Department of Epidemiology, Human Genetics, & Environmental SciencesUTHealth School of Public Health in DallasDallasUSA
  6. 6.Harold C. Simmons Comprehensive Cancer CenterUT Southwestern Medical CenterDallasUSA

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