Cancer survivors' acceptance of technology-based tools for stress management and effective communication

Cancer survivors process complex diagnosis and treatment information making medical appointments a source of stress. Uncertainty about medical decisions heightens stress limiting quality of communication during appointments. Artificial intelligence (AI) tools are emerging as approaches to enhance patient support yet use with Spanish-speaking cancer survivors is limited. This study sought to characterize stress levels of Puerto Rican cancer survivors and assess preparedness before meeting with physicians. We also assessed openness to use technology for stress management and communication with physicians. We hypothesized survivors would report high stress levels, low preparedness, and acceptance of technology. In this cross-sectional study, 169 cancer survivors aged ≥21 were recruited prior to their appointment in oncology waiting rooms. Upon consenting, they completed a survey to assess stress, preparedness, and openness to technology. Stress levels in the past 30 days, prior to appointments, and regarding the current visit were measured. Preparedness for the visit was assessed with a 1-10 scale and asking if they had prepared a list of questions for their physicians. Openness to technology was assessed with questions about willingness to: use a phone/tablet for a relaxation exercise and submit questions electronically for physicians to read before appointments. Statistical analyses were performed using R. Descriptive statistics were used to assess variables of interest. Most study participants (68.6%) were women; mean age 57.8 (SD=14.5). Average age at cancer diagnosis was 55 (SD=14.7). Reasons for visit included routine follow-up (61.7%), test results discussion (9%), first appointment (9%), and follow-up for new symptoms (4.2%). More than a third (36.3%) reported usually/always feeling stress in the past 30 days, 55.6% reported stress prior to appointments, and 53% about their current visit. Despite an average self-reported preparation score of 8.4 (out of 10) and 92% indicating they felt prepared for the visit, only 27% had written a list of questions to guide the conversation with their physician. As for acceptance to technology-based tools, 68% indicated they would benefit from a stress management exercise before appointments and 66% were willing to send questions electronically to their physicians. Among those unwilling, the most common reason was preference for in-person discussion (27.2%). Stress may impair memory interfering with survivors' intentions to ask questions during visits. Findings confirm high pre-appointment stress among cancer survivors and a low tendency to write questions to aid communication. This highlights a need for strategies to enhance emotional readiness and preparedness. Results suggest openness to AI-assisted tools for stress management and improved patient-physician communication, supporting its integration into standard cancer care.