Lauren A Zimmaro1, Kristen A Sorice2, Elizabeth A Handorf2, Mary B Daly2, Jennifer B Reese2. 1. Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA. Electronic address: Lauren.Zimmaro@fccc.edu. 2. Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
Abstract
OBJECTIVES: We aimed to characterize the relationships between breast cancer patient mood symptom severity and demographic/medical factors with clinical communication about mood, and to explore mood discussion content. METHODS: 134 breast cancer patients (mean age=58.3; 14% minority; 13% metastatic) had oncology clinic visits audio-recorded, transcribed, and coded for mood communication. Patient Care Monitor assessed mood symptoms (anxiety/depression presence/severity). Logistic regressions measured associations between mood, demographic/medical factors, and communication. Thematic analysis characterized discussion topics. RESULTS: Over half of patients (55%; n = 73) reported mood symptoms. Worse mood symptoms were associated with younger age and current treatment (p's < 0.05). 19% of clinic visits (n = 26/134) contained mood discussions. Discussions were more common for younger women and those with non-metastatic disease (p's < 0.05). Odds of discussing mood increased with symptom severity (OR=4.52, p = 0.018). Cancer-related anxiety and medication management were among the most common topics discussed. CONCLUSIONS: Communication about mood occurred infrequently, with women currently undergoing treatment, with metastatic disease, or with mild mood symptoms at potentially increased risk for inadequate discussion. Both patient-focused and provider-focused interventions to improve clinical communication about mood symptoms could be beneficial. PRACTICE IMPLICATIONS: Clinicians hold a key role in supporting cancer patients' well-being by using and encouraging effective communication about patients' mood.
OBJECTIVES: We aimed to characterize the relationships between breast cancer patient mood symptom severity and demographic/medical factors with clinical communication about mood, and to explore mood discussion content. METHODS: 134 breast cancer patients (mean age=58.3; 14% minority; 13% metastatic) had oncology clinic visits audio-recorded, transcribed, and coded for mood communication. Patient Care Monitor assessed mood symptoms (anxiety/depression presence/severity). Logistic regressions measured associations between mood, demographic/medical factors, and communication. Thematic analysis characterized discussion topics. RESULTS: Over half of patients (55%; n = 73) reported mood symptoms. Worse mood symptoms were associated with younger age and current treatment (p's < 0.05). 19% of clinic visits (n = 26/134) contained mood discussions. Discussions were more common for younger women and those with non-metastatic disease (p's < 0.05). Odds of discussing mood increased with symptom severity (OR=4.52, p = 0.018). Cancer-related anxiety and medication management were among the most common topics discussed. CONCLUSIONS: Communication about mood occurred infrequently, with women currently undergoing treatment, with metastatic disease, or with mild mood symptoms at potentially increased risk for inadequate discussion. Both patient-focused and provider-focused interventions to improve clinical communication about mood symptoms could be beneficial. PRACTICE IMPLICATIONS: Clinicians hold a key role in supporting cancer patients' well-being by using and encouraging effective communication about patients' mood.
Authors: Jennifer Barsky Reese; Kristen Sorice; Stephen J Lepore; Mary B Daly; James A Tulsky; Mary Catherine Beach Journal: Patient Educ Couns Date: 2018-10-04
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