INFLUENCE OF PHYSICIAN COMMUNICATION ON NEWLY-DIAGNOSED BREAST PATIENTS PSYCHOLOGIC ADJUSTMENT AND DECISION-MAKING

Background. Physician-patient communication is of critical importance when a breast cancer diagnosis is made, because the emotionally overwh elmed patient must be educated about her disease and available treatme nts so she can participate in decisions about her care. A research stu dy addressed the hypothesis that patients whose surgeons used psychoth erapeutic techniques during the cancer diagnostic interview would have better psychologic adjustment to their cancer. Methods. One hundred w omen surveyed 6 months after surgery completed the Cancer Diagnostic I nterview Scale (CDIS) and the SCL-90-R, a measure of psychologic well being. Results. Factor analysis of the CDIS revealed that the physicia n's caring attitude was perceived by the women as most important, with information-giving as a much weaker component. Multiple regression an alysis supported the hypothesis that psychologic adjustment was predic ted by physician behavior during the cancer diagnostic interview. Othe r significant predictors of adjustment were a history of psychiatric p roblems and premorbid life stressors. Conclusions. Provision of inform ation needed for decision-making appears to be valued largely within t he context of a caring physician-patient relationship. Specific surgeo ns' behaviors believed to facilitate patient adjustment include expres sing empathy, allowing sufficient time for patients to absorb the canc er diagnosis, providing information, and engaging the patient in treat ment decision-making.