title: Contribution of emotional distance and reserve in patient-physician communication in healthy study patients, and in patients with benign breast disease and breast cancer: a prospective case-control study in Finland.
abstract: OBJECTIVE
  Emotionally-restricted and 'poor-understanding'communication between a patient and their physician may be associated with difficulties in diagnosis and with poor treatment results in clinical practice. To our knowledge, the associations between distance and reserve in patient-physician communication and the risk of breast cancer (BC) are rarely considered together in a prospective study.
  
  
  METHODS
  In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated for emotional distance and reservation in patient-physician communication before any diagnostic procedures were carried out.
  
  
  RESULTS
  Clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, while 28 individuals were shown to be healthy (HSS). There was a trend for the BC group to report more emotional distance in patient-physician communication (30/34, 89.0%; grade I to IV emotional distance) than the patients in the HSS and BBD groups (78.6% and 75.5%, grade I to IV emotional distance, respectively). However, the mean of the distance score for HSS, BBD and BC groups differed only slightly in grade II and grade III. The BC group had a higher ERS emotional reservation score in contact (25/34, 73.5%; grade I to IV reserve) than the patients in the HSS and BBD groups (57.1% and 62.1%, grade I to IV reserve, respectively). However, the mean of the reserve score for HSS, BBD and BC groups differed only slightly in grade II, grade III and grade IV.
  
  
  CONCLUSIONS
  The results of this study showed that patients with BC could be at risk for emotional distance and reserve in patient-physician communication and this should be taken into account in the relationship between the patient and their physician and may have clinical relevance in day-to-day clinical work.
authors.affiliation: Department of Surgery, Kuopio University Hospital, PL 1777, 70211 Kuopio, Finland. matti.eskelinen@kuh.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Eskelinen
authors.forename: Paula
authors.initials: P
authors.lastname: Ollonen
mesh_terms: D001294:Attitude to Health; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis / Q000523:psychology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology*; D016022:Case-Control Studies; D003142:Communication; D004644:Emotions; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D011379:Prognosis; D011446:Prospective Studies; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
keywords: Patient–physician communication; breast cancer; distance; reserve