Jennifer Barsky Reese1, Mary Catherine Beach2, Katherine Clegg Smith3, Elissa T Bantug4, Kristen E Casale5, Laura S Porter6, Sharon L Bober7, James A Tulsky8, Mary B Daly9, Stephen J Lepore10. 1. Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave., 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA. Jennifer.Reese@fccc.edu. 2. Department of Medicine, Johns Hopkins School of Medicine, 2024 E. Monument St., Baltimore, MD, 21205, USA. 3. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 726, Baltimore, MD, 21205, USA. 4. Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, EB-1650 Orleans St CRB-1 189, Baltimore, MD, 21287, USA. 5. Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave., 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA. 6. Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, DUMC 90399, Durham, NC, 27708, USA. 7. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, Shields-Warren 320, Boston, MA, 02215, USA. 8. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, DA-2016A, Boston, MA, 02215, USA. 9. Department of Clinical Genetics, Fox Chase Cancer Center, 333 Cottman Ave., 4th Floor, Young Pavilion, Philadelphia, PA, 19111, USA. 10. Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Ritter Annex, 9th Floor, Philadelphia, PA, 19122, USA.
Abstract
PURPOSE: Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. METHODS: Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. RESULTS: Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. CONCLUSIONS: Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.
PURPOSE:Breast cancerpatients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. METHODS:Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. RESULTS: Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. CONCLUSIONS: Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.
Entities:
Keywords:
Breast cancer; Communication; Patient-provider communication; Qualitative research; Sexuality
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