title: Communication about sexual health with breast cancer survivors: Variation among patient and provider perspectives.
abstract: Breast cancer survivors experience a range of sexual health (SH) issues. Communication problems between patient and provider can prevent survivors from pursuing SH goals and can negatively influence biopsychosocial outcomes. The primary aims of this study were to identify provider communication behaviors that facilitate or impede clinical interactions regarding SH (according to survivors and providers) and to highlight discrepancies that affect care.
  
  
  
  Forty breast cancer survivors and forty health care providers from a variety of specialties participated in semi-structured interviews informed by the Critical Incident Technique. Transcripts were thematically analyzed using the constant comparative method.
  
  
  
  Survivors and providers discussed the importance of honoring individual patient needs and conveying compassionate messages. However, accounts varied significantly regarding the appropriate timing and method of initiating SH discussions and the helpfulness of certain support behaviors and linguistic devices.
  
  
  
  Provider and survivor accounts of what constitutes helpful and unhelpful provider communication behaviors when discussing SH concerns are misaligned in nuanced and meaningful ways. These discrepancies reveal potential areas for educational intervention.
  
  
  
  SH discussions require providers to examine assumptions about patients' communication preferences and information needs. Patients may benefit from frank yet sensitive discussions earlier in the cancer continuum.
authors.affiliation: Department of Communication, Department of Social Sciences & Health Policy, Wake Forest University/Wake Forest University School of Medicine, Mailing Address: P.O. Box 7347, Winston-Salem NC 27109, (336) 414-8989, United States. Electronic address: canzonmr@wfu.edu.
authors.forename: Mollie Rose
authors.initials: MR
authors.lastname: Canzona
authors.affiliation: Edwards Family Health Clinic, 30 Nightingale Rd., Edwards AFB, CA 93524, United States.
authors.forename: David
authors.initials: D
authors.lastname: Garcia
authors.affiliation: University of Florida Health Cancer Center, UF STEM Translational Communication Center, 2086 Weimer Hall, 1885 Stadium Road, Gainesville, FL 32611, United States.
authors.forename: Carla L
authors.initials: CL
authors.lastname: Fisher
authors.affiliation: Department of Family Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, United States.
authors.forename: Meghan
authors.initials: M
authors.lastname: Raleigh
authors.affiliation: Department of Family Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, United States.
authors.forename: Virginia
authors.initials: V
authors.lastname: Kalish
authors.affiliation: Department of Family Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, Department of Family Medicine, National Capital Consortium Family Medicine Residency, 9300 DeWitt Loop, Fort Belvoir, VA 22060, United States.
authors.forename: Christy J W
authors.initials: CJ
authors.lastname: Ledford
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology*; D003075:Coitus / Q000502:physiology / Q000523:psychology*; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D060728:Reproductive Health; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: Breast cancer; Patient-provider communication; Sexual health; Survivorship