Low self-efficacy is associated with decreased emergency department use in underserved men with prostate cancer.

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.

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.

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.

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.

Urologic oncology. 2015 Sep 24 [Epub ahead of print]

Avi S Baskin, Lorna Kwan, Sarah E Connor, Sally L Maliski, Mark S Litwin

Department of Urology, David Geffen School of Medicine at the University of California, Los Angeles, CA. Electronic address: ABaskin@mednet. ucla. edu. , Department of Urology, David Geffen School of Medicine at the University of California, Los Angeles, CA. , Department of Urology, David Geffen School of Medicine at the University of California, Los Angeles, CA. , School of Nursing, University of California, Los Angeles, CA. , Department of Urology, David Geffen School of Medicine at the University of California, Los Angeles, CA; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA.

PubMed