COMMUNICATION BETWEEN PATIENTS WITH BREAST-CANCER AND HEALTH-CARE PROVIDERS

Background. This study evaluated the perceptions of patients with brea st cancer of their medical interactions with providers. The determinan ts and psychological consequences of communication problems also were examined. Methods. Ninety-seven patients with Stage I or II breast can cer completed a set of validated questionnaires before initiating post operative therapy. Data on psychological distress were collected at ba seline and 3-month follow-up, and multivariate models were fit to expl ain the relationship between pretreatment communication problems and s ubsequent psychological distress. Data on clinical variables were abst racted from medical records. Results. A substantial proportion of pati ents (84%) reported difficulties communicating with the medical team. Communication problems were more common among patients who were less o ptimistic about their disease and had less assertive coping styles. Pa tient-reported communication problems were associated with increased a nxiety, depression, anger, and confusion at the 3-month follow-up. The association between communication problems and mood disturbance remai ned significant, although small, after adjusting for baseline mood dis turbance, demographic, clinical, and coping style variables. Conclusio n. Interventions that enhance communication between patients with brea st cancer and their providers may improve patients' psychological adju stment to treatment. Conversely, interventions that lower distress and modify coping style may enhance communication.