title: Doctor-patient communication: results of a four-year prospective study in rectal cancer patients.
abstract: OBJECTIVE
  The purpose of the study was to examine the effect of communication on rectal cancer patients' quality of life over four years. Previous studies have either used short follow-up periods or examined only certain aspects of quality of life, such as anxiety and depression.
  
  
  METHODS
  In a prospective, observational study, rectal cancer patients, recruited by clinicians over a two-year period, were sent questionnaires over four years. The clinical details of these patients were recorded by the Munich Cancer Registry. The psychological scores from the European Organization for Research and Treatment of Cancer QLQ-C30 and CR38 were the main outcome variables.
  
  
  RESULTS
  Thirty-nine percent of the sample reported that some aspect of the communication they received was unclear (incomprehensible or too little). More than 60 percent wished to speak more with their physician. Younger patients and those in larger hospitals were more likely to report unclear communication (P < 0.05). Analyses of covariance, controlled for age, gender, adjuvant therapy, stoma, education, clinic, and comorbidity, demonstrated that role, emotional, and social functioning scores were consistently lower in patients reporting unclear communication. Additionally, these patients experienced more problems sleeping, poorer body image, more financial worries, and a worse future perspective. Repeated measures analyses indicated that sleeping problems and emotional and social functioning difficulties persisted for at least three years.
  
  
  CONCLUSIONS
  Reports of unclear communication were associated with poorer quality of life in rectal cancer patients without disease progression.
authors.affiliation: Feldstudie, Munich Cancer Registry, Ludwig-Maximilians University, Munich, Germany.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Kerr
authors.forename: Jutta
authors.initials: J
authors.lastname: Engel
authors.forename: Anne
authors.initials: A
authors.lastname: Schlesinger-Raab
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Sauer
authors.forename: Dieter
authors.initials: D
authors.lastname: Hölzel
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003142:Communication; D018450:Disease Progression; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000523:psychology* / Q000628:therapy; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires