title: Communication between patients with breast cancer and health care providers. Determinants and implications.
abstract: BACKGROUND
  This study evaluated the perceptions of patients with breast cancer of their medical interactions with providers. The determinants and psychological consequences of communication problems also were examined.
  
  
  METHODS
  Ninety-seven patients with Stage I or II breast cancer completed a set of validated questionnaires before initiating postoperative therapy. Data on psychological distress were collected at baseline and 3-month follow-up, and multivariate models were fit to explain the relationship between pretreatment communication problems and subsequent psychological distress. Data on clinical variables were abstracted from medical records.
  
  
  RESULTS
  A substantial proportion of patients (84%) reported difficulties communicating with the medical team. Communication problems were more common among patients who were less optimistic about their disease and had less assertive coping styles. Patient-reported communication problems were associated with increased anxiety, depression anger, and confusion at the 3-month follow-up. The association between communication problems and mood disturbance remained significant, although small, after adjusting for baseline mood disturbance, demographic, clinical, and coping style variables.
  
  
  CONCLUSIONS
  Interventions that enhance communication between patients with breast cancer and their providers may improve patients' psychological adjustment to treatment. Conversely, interventions that lower distress and modify coping style may enhance communication.
authors.affiliation: Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: C
authors.initials: C
authors.lastname: Lerman
authors.forename: M
authors.initials: M
authors.lastname: Daly
authors.forename: W P
authors.initials: WP
authors.lastname: Walsh
authors.forename: N
authors.initials: N
authors.lastname: Resch
authors.forename: J
authors.initials: J
authors.lastname: Seay
authors.forename: A
authors.initials: A
authors.lastname: Barsevick
authors.forename: L
authors.initials: L
authors.lastname: Birenbaum
authors.forename: T
authors.initials: T
authors.lastname: Heggan
authors.forename: G
authors.initials: G
authors.lastname: Martin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000523:psychology*; D003142:Communication; D005260:Female; D006282:Health Personnel; D006801:Humans; D008875:Middle Aged