The psychological responses of outpatient breast cancer patients before and during first medical consultation.
OBJECTIVE
The purpose of this study was to qualitatively examine the content of the psychological responses in interviews with breast cancer outpatients receiving initial medical consultation.


METHODS
The participants were 180 people who visited the breast cancer outpatient clinic at Kitasato University Hospital between November 2004 and August 2005. The remaining 176 participants (39 breast cancer patients and 137 benign tumor patients; average age +/- SD: 50.7 +/- 12.4 years) were analyzed. Two clinical psychologists carried out the interview, asking the participants to speak freely about their anxieties, worries, thoughts, and feelings up until the medical examination. This study used a content analysis of interviews to chronologically examine psychological response of cancer patients seeking medical consultation at three points in time.


RESULTS
Patients at the time of their first outpatient breast cancer consultation experience negative feelings before the examination, directly influenced by the suspicion of cancer. These include anxiety and worries, fear, evasion, depression, and impatience. These tendencies do not change at the time of consultation. However, in addition to negative feelings, some people also possess positive feelings, either simultaneously or at a different point in time. Further, many patients tend to talk at length about psychological responses before seeking treatment, understanding the process they went through to come to seek treatment as an important event.


CONCLUSIONS
It is important for medical workers to bear in mind the psychological conflicts that patients may undergo before seeking treatment and ensure that sufficient communication takes place.
Department of Medical Psychology, Kitasato University, Graduate School of Medical Sciences, Kanagawa, Japan. hirayama.s@yamatokai.or.jp
Shigemi
S
Okazaki
Yumi
Y
Iwamitsu
Kuranami
K
Masaru
Keiko
K
Todoroki
Shimako
S
Suzuki
Kenji
K
Yamamoto
Masashi
M
Hagino
Masahiko
M
Watanabe
Hitoshi
H
Miyaoka
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003469:Culture; D003674:Defense Mechanisms; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005239:Fear; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D011379:Prognosis; D012017:Referral and Consultation