title: What to listen for in the consultation. Breast cancer patients' own focus on talking about acceptance-based psychological coping predicts decreased psychological distress and depression.
abstract: OBJECTIVE
  To analyze whether qualitative themes in breast cancer patients' self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process.
  
  
  METHODS
  Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression scale (CES-D).
  
  
  RESULTS
  Among the qualitative themes, only the percentage of words spent on talking about 'Acceptance-based psychological coping' was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted less psychological distress and depression, respectively. A cross-validation including only the first few minutes of speech per patient confirmed these results and supported their practical utility in health consultations.
  
  
  CONCLUSIONS
  Patients' focus on acceptance-based coping significantly predicted decreased psychological distress and depression, respectively. No other qualitative themes predicted symptoms. Doctor-patient studies may benefit from combined qualitative-quantitative methods.
  
  
  CONCLUSIONS
  While quantitative symptom assessment is important for a consultation, health care providers may improve their understanding of patients by attending to patients' presentations of acceptance-based psychological coping.
authors.affiliation: Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Dep. 6931, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: cgjensen@nru.dk.
authors.forename: Christian Gaden
authors.initials: CG
authors.lastname: Jensen
authors.affiliation: Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Elsass
authors.affiliation: Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Line
authors.initials: L
authors.lastname: Neustrup
authors.affiliation: Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Tina
authors.initials: T
authors.lastname: Bihal
authors.affiliation: Herlev Hospital, Herlev, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Flyger
authors.affiliation: Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Signe Maria
authors.initials: SM
authors.lastname: Kay
authors.affiliation: Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Sadia
authors.initials: S
authors.lastname: Khan
authors.affiliation: Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Sivi Svenning
authors.initials: SS
authors.lastname: Jensen
authors.affiliation: Ringsted Hospital, Ringsted, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Pedersen
authors.affiliation: Department of Psychosocial Cancer Research at the Institute of Cancer Epidemiology, The Danish Cancer Society (EPI), Copenhagen, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Würtzen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D064866:Mindfulness; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012017:Referral and Consultation; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Cancer; Consultation; Coping; Illness perception; Mindfulness; Mixed methods; Self-presentation