Patient-Clinician Communication, Care Coordination, Relational Continuity, and Treatment-Related Anxiety in Gynecologic Oncology
DOI:
https://doi.org/10.61919/7zj0q965Keywords:
Gynecologic Neoplasms; Treatment-Related Anxiety; Patient–Clinician Communication; Care Coordination; Continuity of Care; Patient Navigation; Cross-Sectional Studies.Abstract
Background: Treatment-related anxiety is an important concern among patients with gynecologic malignancies, particularly during diagnostic evaluation, treatment planning, and transitions between healthcare services. Patient–clinician communication, care coordination, and relational continuity may be associated with psychological experiences during these periods, although their independent contributions remain insufficiently characterized. Objective: To examine the associations of patient–clinician communication quality, perceived care coordination, and relational continuity/navigation support with treatment-related anxiety among adults with gynecologic malignancies after adjustment for demographic and clinical characteristics. Methods: A cross-sectional quantitative analysis was conducted using structured participant-level data from 240 adults with gynecologic malignancies. Communication quality, care coordination, relational continuity/navigation support, and treatment-related anxiety were assessed using study-specific questionnaires comprising 8, 8, 6, and 8 items, respectively, rated on five-point Likert scales. Internal consistency was assessed using Cronbach's alpha. Pearson correlation, independent-samples t-tests, one-way analysis of variance, and hierarchical multiple linear regression were used to examine associations and group differences. The adjusted regression accounted for age, cancer stage, cancer type, initial treatment, diagnosis-to-treatment interval, and perceived family support. Results: The questionnaire composites demonstrated high internal consistency, with Cronbach's alpha values of 0.919 for communication quality, 0.914 for care coordination, 0.905 for relational continuity/navigation support, and 0.926 for treatment-related anxiety. Anxiety was inversely correlated with communication quality (r = −0.465), care coordination (r = −0.392), and relational continuity/navigation support (r = −0.445; all p < 0.001). Participants with advanced-stage disease reported higher anxiety than those with early-stage disease (mean difference = 0.377; 95% CI: 0.194–0.560; p < 0.001; Cohen's d = 0.53). In the fully adjusted regression, communication quality (β = −0.339), care coordination (β = −0.233), and relational continuity/navigation support (β = −0.289) remained inversely associated with anxiety (all p < 0.001). Higher cancer stage (β = 0.292) and longer diagnosis-to-treatment intervals (β = 0.256) were associated with greater anxiety, whereas stronger family support was associated with lower anxiety (β = −0.121; p = 0.010). The final model explained 55.9% of anxiety-score variance (adjusted R² = 0.532), with the three care-process variables contributing an additional 37.0 percentage points beyond the demographic and clinical covariates (ΔR² = 0.370; p < 0.001). Conclusion: Better perceived patient–clinician communication, care coordination, and relational continuity/navigation support were independently associated with lower treatment-related anxiety among adults with gynecologic malignancies. These findings highlight the relevance of interpersonal and organizational care experiences alongside clinical characteristics. Prospective studies and further validation of the study-specific measures are needed to establish temporal relationships and evaluate potential clinical applications.
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