title: What do women with breast cancer expect from their treatment? Correlates of negative treatment expectations about endocrine therapy.
abstract: Patients' negative treatment expectations can lead to nocebo-related side effects and non-initiation of treatment. This study aims to identify correlates of treatment expectations in patients with breast cancer before the start of endocrine therapy.
  
  
  
  Expectations were assessed in a cross-sectional sample of 166 patients with breast cancer after receiving treatment information. Side effect expectations (one item) and treatment necessity-concern balance (Beliefs about Medicines Questionnaire) were assessed. Correlates were analyzed using regression analyses. The structure of treatment expectations was investigated using a network analysis.
  
  
  
  About 25% of patients expressed negative expectations. Higher side effect expectations were associated with lower treatment efficacy expectations (ß = -0.20, p = 0.01), higher medication overuse beliefs (ß = 0.17, p = 0.01), and a negative treatment appraisal before study treatment information (ß = -0.17, p = 0.02). A negative necessity-concern balance was associated with lower treatment efficacy expectations (ß = 0.36, p < 0.001), lower adherence intention (ß = 0.21, p < 0.001), and no knowledge of tumor's receptor status (ß = 0.21, p < 0.001); furthermore, it was associated with higher medication harmfulness beliefs (ß = -0.16, p = 0.02), negative treatment pre-appraisal (ß = 0.15, p = 0.01), higher somatosensory amplification (ß = -0.14, p = 0.02), and higher education (ß = -0.12, p = 0.02). The most important network node was the concern that endocrine therapy disrupts life.
  
  
  
  Negative treatment expectations before treatment start are mainly associated with psychological variables. These results are relevant for patient education in clinical settings. To improve expectations, clinicians might emphasize treatment efficacy and discuss general and specific medication concerns. Improving treatment knowledge could also be beneficial. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Clinical Psychology and Psychotherapy, Hamburg University, Hamburg, Germany.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Heisig
authors.affiliation: Clinical Psychology and Psychotherapy, Hamburg University, Hamburg, Germany.|Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Meike C
authors.initials: MC
authors.lastname: Shedden-Mora
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University, Marburg, Germany.
authors.forename: Pia
authors.initials: P
authors.lastname: von Blanckenburg
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University, Marburg, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
authors.affiliation: Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Isabell
authors.initials: I
authors.lastname: Witzel
authors.affiliation: Department of Gynecology, Philipps-University, Marburg, Germany.|Department of Gynecology and Obstetrics, Krankenhaus Nordwest, Frankfurt am Main, Germany.
authors.forename: Ute-Susann
authors.initials: US
authors.lastname: Albert
authors.affiliation: Clinical Psychology and Psychotherapy, Hamburg University, Hamburg, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Nestoriuc
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D006801:Humans; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy* / Q000523:psychology*; D064786:Nocebo Effect; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D047072:Aromatase Inhibitors; D013629:Tamoxifen
keywords: beliefs about medication; breast cancer; informed consent in oncology; necessity-concern balance; nocebo; side-effect expectations