title: Patient-provider communication and perceived control for women experiencing multiple symptoms associated with ovarian cancer.
abstract: OBJECTIVE
  Optimal cancer symptom management requires effective patient-health care provider (HCP) communication. The goals of this study were to 1) describe symptom experiences of women with ovarian cancer, 2) evaluate frequency of patient-HCP communication about symptoms, and 3) evaluate whether communication is associated with patients' confidence in managing symptoms.
  
  
  METHODS
  This was a cross-sectional mailed survey study. The Symptom Experience Survey, containing valid, reliable measures of symptom severity and controllability; symptom communication; and symptom-related coping strategies, was mailed to members of the National Ovarian Cancer Coalition. Descriptive statistics, t tests, correlations, and ANCOVA were used to address study objectives.
  
  
  RESULTS
  This analysis focuses on the 279 respondents who had active disease. The majority of women had recurrent disease (96%) and were on chemotherapy (57%). Women reported a mean of 12 concurrent symptoms. Fatigue, bowel disturbances, and peripheral neuropathies were the most severe and most noticed symptoms. Only 61% of women had discussed their most noticed symptom with an HCP in the past month, and only 50% of women reported that they had received symptom management recommendations. Women reported low levels of perceived control over symptoms (M = 1.97 on a 0-4 scale). There was a significant interaction effect for symptom discussions and management recommendations on perceived control. Women who had never received recommendations had low perceived control whether or not they had discussed their symptom with an HCP in the past month. For women who had received recommendations, those who had discussed their symptom with an HCP in the past month had higher perceived control compared to those who had not discussed their symptom.
  
  
  CONCLUSIONS
  Women with ovarian cancer experience multiple symptoms, but many do not discuss symptoms with their HCPs and fewer report receiving symptom management recommendations. Women would benefit from more active symptom assessment and discussion of management strategies by HCPs.
authors.affiliation: Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA. donovanh@pitt.edu
authors.forename: Heidi Scharf
authors.initials: HS
authors.lastname: Donovan
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Hartenbach
authors.forename: Michael W
authors.initials: MW
authors.lastname: Method
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology / Q000628:therapy; D010051:Ovarian Neoplasms / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D010817:Physician-Patient Relations; D012893:Sleep Wake Disorders / Q000209:etiology