Patient health engagement as a predictor of symptom outcomes in patients receiving chemotherapy.

PURPOSE: Patient health engagement (PHE), reflecting psychological readiness to participate in care, may influence how patients cope with symptoms. This study explored the associations between PHE and symptom outcomes in cancer patients receiving outpatient chemotherapy. METHODS: A secondary analysis of baseline data was conducted among 79 patients with gastrointestinal or hematological cancers. PHE was assessed using the Patient Health Engagement Scale (PHE-s; range 1-4). Symptom intensity was measured using the Edmonton Symptom Assessment Scale-revised (ESASr), and daily life interference with the MD Anderson Symptom Inventory-Interference scale (MDASI). Multivariate regression models tested the predictive value of PHE, adjusting for psychosocial covariates, age, and cancer type. RESULTS: The mean PHE score was 3.1 (SD = 0.6; range 1.6-4.0), with one-third of patients scoring below 3, indicating low engagement. Higher PHE predicted lower overall symptom intensity (β = -0.42, p < 0.001), emotional symptoms (β = -0.56, p < 0.001), and interference in daily life (β = -0.46, p < 0.001). Although PHE was associated with physical symptom intensity (β = -0.29, p = 0.024), the overall model was not significant, and ROC analysis showed poor discrimination. ROC analyses identified domain-specific PHE cut-off scores (≤ 2.3-2.9) that distinguished between low and high symptom burden for total, emotional, and interference outcomes. CONCLUSION: PHE, particularly psychological readiness, was associated with better overall, emotional, and functional symptom outcomes. Identifying patients with low engagement may enable more timely, tailored supportive care. Future research should validate these findings in larger and more diverse groups.