title: The surgeon-patient interaction in older women with breast cancer: what are the determinants of a helpful discussion?
abstract: BACKGROUND
  Surgery is a key modality in the treatment of breast cancer. The patient-physician interaction is a key determinant of a range of outcomes, but there is little work examining the surgeon-breast cancer patient interaction. We analyzed data from 240 women with a new breast cancer diagnosis to better understand this interaction and to delineate the patient, surgeon, and surgeon-patient interaction-level characteristics affecting this interaction.
  
  
  METHODS
  A cross-sectional survey was conducted in Los Angeles County of 240 women with a new breast cancer diagnosis aged>or=55 years. Women were asked to rate on a scale of 0 to 10 how helpful overall the way their surgeon discussed their breast cancer with them was. Logistic regression models were constructed to assess the relationship of patient, surgeon, and surgeon-patient interaction characteristics to the outcome variable.
  
  
  RESULTS
  Forty-four percent of women said that they found the way their surgeon discussed their breast cancer with them extremely helpful. Women with a higher level of perceived self-efficacy, a longer consultation time with the surgeon, a higher interactive information-giving score, and a higher participatory decision-making score had significantly higher odds of reporting the discussion to be "extremely helpful."
  
  
  CONCLUSIONS
  Our results indicate that strategies to improve the patient's perceived self-efficacy (preparing questions beforehand, practicing, watching a role model, and so on) will improve the surgeon-patient discussion. At a systems level, adequate time should be budgeted for the consultation, and we must ensure that adequate communication skills are imparted to surgeons during their educational training.
authors.affiliation: Department of Family Medicine, Schulich School of Medicine, University of Western Ontario, 245-100 Collip Circle, London, Ontario, N6G 4X8, Canada. athind2@uwo.ca
authors.forename: Amardeep
authors.initials: A
authors.lastname: Thind
authors.forename: Rose
authors.initials: R
authors.lastname: Maly
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D015141:Los Angeles; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D020377:Self Efficacy