The human connection: Oncologist characteristics that facilitate therapeutic bonding among Latino patients with advanced cancer.

person Ana Isabel Tergas City of Hope National Medical Center, Duarte, CA info_outline Ana Isabel Tergas, Holly Gwen Prigerson, Frank J. Penedo, Paul K. Maciejewski

Authors person Ana Isabel Tergas City of Hope National Medical Center, Duarte, CA info_outline Ana Isabel Tergas, Holly Gwen Prigerson, Frank J. Penedo, Paul K. Maciejewski Organizations City of Hope National Medical Center, Duarte, CA, Weill Cornell Medicine, New York, NY, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL Abstract Disclosures Research Funding U.S. National Institutes of Health U.S. National Institutes of Health Background: Therapeutic alliances (TA) are bonds between patients and their oncologists characterized by mutual caring, trust, understanding, and respect. They lay the foundation for the provision of high-quality cancer care. We here relate oncologist characteristics to TA in Latino vs. non-Latino advanced cancer patients. Results will inform the development of an intervention to train oncologists in how to develop a strong TA with their Latino patients. Methods: The study population included non-Latino oncologists (n = 41) and their Latino (n = 67) and non-Latino white (n = 90) patients with advanced cancers who participated in Coping with Cancer III, a multi-site prospective cohort study designed to examine Latino/non-Latino disparities in advance care planning and end-of-life cancer care, conducted at U.S. medical centers from 2015-2019. Oncologist characteristics included age, sex, race, institution type, Spanish language proficiency and practice style behaviors (e.g., “familismo”— embracing dedication, commitment, and loyalty to family), addressing patients by their first name, and personal disclosure (e.g., “personalismo”), among others. The average score of 6 items from The Human Connection scale was used to assess the patients’ TA with their oncologists. Hierarchical linear modeling (HLM) was used to evaluate the effects of oncologist characteristics on TA in the full patient sample and stratified by patient ethnicity. Results: Of the 157 patients, 67 (42.7%) were Latino; most were female (n = 92, 58.6%) and < 65 years old (n = 95, 60.5%). Most oncologists were male (n = 24, 58.5%), non-Latino? white (n = 25, 61%), and ≥ 40 years (n = 25, 61%). There were no significant associations between patient age, sex, Medicaid recipient status, education level, marital status, and geographic region with TA. An adjusted HLM in the full sample showed that Latino ethnicity was associated with significantly lower TA (b = −0.16, p = 0.037). In an adjusted HLM for TA stratified by ethnicity, oncologist preference to address patients by their first names (b = 0.34, p = 0.001) and a “familismo” practice style (b = 0.46, p = 0.001) were positively associated with TA among Latino patients. In contrast, “familismo” had no impact on TA for the non-Latino white patients. Conclusions: In this study, Latino patients with advanced cancer had a worse therapeutic alliance with their oncologists compared to non-Latino patients. Cultural differences between Latino and non-Latino white patients may be leveraged in an intervention designed to improve the therapeutic bonding and patient-clinician relationship between oncologists and their Latino patients with advanced cancer, thus potentially mitigating cancer care disparities in this important, often underserved, patient population.