CHEST Guidelines-Association-of-Communication-Quality-With-Patient-

Association-of-Communication-Quality-With-Patient-

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This study investigates the effect of high-quality communication between physicians and patients on patient-centered outcomes among veterans diagnosed with incidental pulmonary nodules at the VA Portland Health Care System. The focus is on symptoms such as depression, anxiety, and worry about lung cancer. Given the high prevalence of distress and anxiety often associated with detecting such nodules, the hypothesis posited that better communication might improve these outcomes.<br /><br />In a longitudinal, repeated-measures cohort study spanning June 2011 to November 2015, 104 patients with incidental nodules of ≤3 cm were monitored. The study excluded those with prior lung cancer, cognitive disorders, or residing in skilled nursing facilities. High-quality communication was evaluated using the Consultation Care Measure, with responses indicating high-quality communication if patients strongly agreed that their provider's communication was excellent.<br /><br />Findings revealed that while high-quality communication was associated with statistically lower mean depression scores, the clinical significance of this reduction was minimal. Furthermore, no significant association was observed between communication quality and symptoms of anxiety or lung cancer worry. In sensitivity analyses, no relationship between communication quality and any of the three primary outcomes was found.<br /><br />The study underscores that while quality communication is crucial, its impact on emotional outcomes for patients with pulmonary nodules may be limited, suggesting that alternative interventions might be necessary. Additionally, the study was limited by its small size, lack of ethnic diversity, and generalizability constraints as most participants were White male veterans. <br /><br />Ultimately, while effective communication remains a valuable component of patient care, its ability to mitigate emotional distress or enhance psychological outcomes in patients with incidental pulmonary nodules appears restricted, pointing to the need for supplementary strategies in managing these patients’ concerns.

Keywords

high-quality communication

patient-centered outcomes

veterans

incidental pulmonary nodules

VA Portland Health Care System

depression

anxiety

lung cancer worry

Consultation Care Measure

emotional distress