title: Does physician communication style impact patient report of decision quality for breast cancer treatment?
abstract: Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer.
  
  
  
  Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive).
  
  
  
  Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality.
  
  
  
  Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication.
  
  
  
  Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality.
authors.affiliation: Cleveland Clinic, Center for Value-Based Care Research, 9500 Euclid Ave, G10 Cleveland, OH 44195, USA. Electronic address: martink12@ccf.org.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Martinez
authors.affiliation: University of Michigan School of Public Health, 109 Observatory Street Ann Arbor, MI 48109-2029, USA. Electronic address: kresnic@umich.edu.
authors.forename: Ken
authors.initials: K
authors.lastname: Resnicow
authors.affiliation: University of Rochester, School of Medicine, 500 Joseph C. Wilson Blvd Rochester, NY 14611, USA. Electronic address: Geoffrey_Williams@URMC.Rochester.edu.
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Williams
authors.affiliation: University of Lisbon, Faculty of Human Kinetics, Estrada da Costa, 1495-710, Cruz Quebrada, Lisbon, Portugal. Electronic address: mnsilva@fmh.ulisboa.pt.
authors.forename: Marlene
authors.initials: M
authors.lastname: Silva
authors.affiliation: University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: pabraham@med.umich.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Abrahamse
authors.affiliation: University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: dshumway@med.umich.edu.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Shumway
authors.affiliation: University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: lwallner@med.umich.edu.
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Wallner
authors.affiliation: University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: skatz@med.umich.edu.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Katz
authors.affiliation: University of Michigan School of Medicine, 2800 Plymouth Road, Ann Arbor, MI 48109, USA. Electronic address: sarahawl@med.umich.edu.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010358:Patient Participation; D017060:Patient Satisfaction; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*
keywords: Breast cancer; Decision making; Decision quality; Patient autonomy; Provider communication