Internalizing Patient-Centered Communication: Pathways to Telehealth Efficacy in Cancer Care

As telehealth becomes increasingly central to cancer care, many patients still report low confidence navigating digital communication with providers. Grounded in self-determination theory, this study investigates how patient-centered communication (PCC) in clinical settings can foster patient activation, thereby enhancing patients' efficacy in using telehealth tools. Using a sample of 495 Chinese cancer patients with telehealth experience, we conducted path analysis to examine how six PCC functions relate to four progressive stages of patient activation (role importance, confidence, action, and endurance), and how these, in turn, predict telehealth efficacy. PCC functions such as shared decision-making and support for self-management significantly predicted higher levels of patient activation. Activation stages, particularly role importance and action, were associated with stronger telehealth efficacy. PCC effects on efficacy were fully mediated by activation stages, suggesting an internalization pathway where clinical communication transforms into patients' self-confidence and competence in telehealth contexts. By linking PCC to telehealth efficacy through motivation dynamics, this study advances both theoretical and practical understandings of telehealth care. To support confident use of telehealth among cancer patients, providers should adapt communication strategies that go beyond information delivery to build patients' autonomy and competence, especially among vulnerable populations with low digital confidence.