Low self-efficacy is associated with decreased emergency department use in underserved men with prostate cancer.
Urol Oncol
; 34(1): 3.e15-21, 2016 Jan.
Article
in En
| MEDLINE
| ID: mdl-26411548
ABSTRACT
BACKGROUND:
Self-efficacy has been strongly associated with health behavior and health maintenance. We examined the relationship between patient-provider self-efficacy and emergency department usage in low-income, underinsured, or uninsured patients with prostate cancer.METHODS:
We prospectively analyzed quality of life, behavior, and self-efficacy data from men enrolled in a state-funded program providing free prostate cancer care. We summarized patient characteristics stratified by self-efficacy scores (high, mid, and low) and by emergency department visit (any vs. none). We conducted a multivariate repeated measures regression analysis with negative binomial distribution to calculate predicted counts of emergency department visits over time across the self-efficacy strata.RESULTS:
Our cohort included 469 men with a maximum follow-up time of 84 months. Of these men, 70 had visited the emergency department during their enrollment for a total of 118 unique visits. The regression analysis demonstrated a decreasing number of emergency department visits over time for the low (P = 0.0633) and mid (P = 0.0450) self-efficacy groups but not for the high self-efficacy group (P = 0.1155). Pain (22.9%), urinary retention (18.6%), and fever (5.9%) were the most common reasons for emergency department visits.CONCLUSIONS:
Patients with low and mid self-efficacy had a decreasing number of emergency department usage over time. Those with high self-efficacy did not follow these trends. Interventions to improve communication between patients and primary treatment teams could prove beneficial in avoiding excess emergency department use.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatic Neoplasms
/
Quality of Life
/
Self Efficacy
/
Emergency Service, Hospital
/
Medically Underserved Area
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Urol Oncol
Journal subject:
NEOPLASIAS
/
UROLOGIA
Year:
2016
Type:
Article