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Aisha's Dissertation finalized .pdf (1.85 MB)

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The Effects of Provider Communication Behaviors and Shared Decision Making On Quality of Life Among Patients with Advanced Cancer in Saudi Arabia

Alhofaian, Aisha Mohammed
http://rave.ohiolink.edu/etdc/view?acc_num=case1528391142691034

Abstract Details

2018, Doctor of Philosophy, Case Western Reserve University, Nursing.
Patients with advanced cancer from Saudi Arabia (SA) are often not well informed about diagnoses, prognoses, and treatment options. Poor communication can lead to health care decisions that insufficiently meet patients’ preferences, concerns, and needs and that subsequently affect patient quality of life. Effective provider communication behaviors are needed to ensure that patients make informed and shared decisions about treatment, enable them to adhere to advice about managing their diseases, and help them adjust and adapt to the fact that they have a life-threatening disease. Evidence supports a positive relationship between shared decision making approaches and a patient’s quality of life. However, little is known regarding how cancer patients and providers communicate and make treatment decisions in SA. Therefore, the purpose of this study was to examine the relationships among provider communication behaviors, shared decision making, and quality of life for patients with advanced cancer in Saudi Arabia. Theoretical framework: Street’s ecological theory of patient-centered communication (2009) was used to guide this study. This theory stipulates that communication between patients and providers influences their shared decision making and that shared decision making can help providers make treatment recommendation to meet patient’s needs and patients with an advanced cancer diagnosis to adhere to provider recommendations to improve their quality of life. Methods: A cross-sectional descriptive correlational study was used and a convenience sample of 159 patients with stage III and IV solid cancer was recruited from King Abdul Aziz University (KAAU) hospitals in Jeddah, Saudi Arabia. The researcher orally administered all three questionnaires, and obtained demographic data using Qualtric survey. Results: 1) In the simple regression analysis, there was a significant positive relationship between provider communication behaviors and patient quality of life (ß = .18, b =.35. SE= .15, p = .021); 2), and between shared decision making and patient quality of life (ß = .20, b = .41, SE= .16, p = .013); 2). In a mediation analysis, the shared decision making did not mediate the relationship between provider communication behaviours and patient quality of life ; 3) The multiple linear regression model with four predictors was statistically significant and explained 11.4 % of the variance in quality of life, R2 = 0.11, F (4,154) = 4.98, p = 0.001; Age was the only significant predictor of quality of life for patients with advanced cancer (Unstandarized ß coefficient= -.39, p<0.05). Conclusions: The findings show that age significantly predicted patients’ quality of life in this study, but the influence of provider communication behavior and shared decision-making on quality of life is limited. The findings are likely explained by the cultural context of modern Saudi Arabian society in which family plays a significant role in communication with providers about patients’ treatments and the treatment decision making process may be independent of patient-provider communication. However, the participants were recruited only from KAAU hospitals in Jeddah, which may limit the generalizability of the findings. Implications: The findings of this study have several implications for theory, clinical practice, nursing research, and health policy. Future studies should give more consideration to family communication with health care providers in order to better identify factors that affect cancer patients’ quality of life in Saudi Arabia and also inform providers about how to improve the quality of care for cancer patients.
Amy Zhang (Advisor)
Faye Gary (Committee Member)
Matthew Plow (Committee Member)
Cynthia Owusu (Committee Member)
Communication; Medicine; Nursing
Advanced cancer; Saudi Arabia; Provider communication behaviors; Quality of life

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Citations

  • Alhofaian, A. M. (2018). The Effects of Provider Communication Behaviors and Shared Decision Making On Quality of Life Among Patients with Advanced Cancer in Saudi Arabia [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1528391142691034

    APA Style (7th edition)

  • Alhofaian, Aisha. The Effects of Provider Communication Behaviors and Shared Decision Making On Quality of Life Among Patients with Advanced Cancer in Saudi Arabia . 2018. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1528391142691034.

    MLA Style (8th edition)

  • Alhofaian, Aisha. "The Effects of Provider Communication Behaviors and Shared Decision Making On Quality of Life Among Patients with Advanced Cancer in Saudi Arabia ." Doctoral dissertation, Case Western Reserve University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case1528391142691034

    Chicago Manual of Style (17th edition)

case1528391142691034
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This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.