Relationships Between Clinician-Patient Communication and the Quality of Life of Patients With Leukaemia: A Prospective Cross-Sectional Global Study

临床医生与患者沟通与白血病患者生活质量的关系:一项前瞻性横断面全球研究

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Abstract

IntroductionThis study examined relationships between patient reported quality of life and demographic, disease related, and clinician-patient communication variables in people with leukaemia, using a validated haematological malignancy specific patient-reported outcome measure to provide insights to help improve care and enhance patient well-being.MethodsA prospective global cross-sectional online questionnaire study was conducted, with people self-identifying as patients with leukaemia, that included 100 items on demographics, information on communication, disease and treatment and the Haematological Malignancy Patient-Reported Outcome (HM-PRO) instrument. The HM-PRO scores were analysed using Kruskal-Wallis tests and Gradient Boosting Decision Trees (GBDTs) to identify key factors associated with patient outcomes.Results2,260 patients with leukaemia participated, from 64 countries, of whom 1,993 completed the HM-PRO Part-A (measure of QoL) and 1,951 completed Part-B (signs and symptoms). The HM-PRO scores varied significantly by demographic factors, with younger patients (18-25) and people with acute leukaemia reporting the highest scores. Communication about treatment decisions and side effects was significantly associated with HM-PRO scores (η(2): 0.012-0.063). GBDT models had high Area Under Curve but low accuracy: isolation and depression emerged as key predictors of QoL classification.ConclusionImproved clinician-patient communication and psychosocial support may mitigate the burden of leukaemia. Tailored, person-centred approaches integrating medical and emotional care could improve QoL, treatment adherence, and outcomes, particularly for younger patients and people facing significant treatment challenges. However, given the cross-sectional design, causal inferences cannot be made. We note our findings are presented strictly as associations observed in cross-sectional data, and we acknowledge the potential for bidirectional relationships between QoL and the variables explored. The findings primarily reflect the experiences of individuals who are more engaged, digitally included, or connected to advocacy organisations, rather than the broader leukaemia population.

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