Breast cancer patients' experiences of patient-doctor communication: a working relationship

The traumas of diagnosis and treatment for breast cancer are well researche d and generally addressed in care. While women with breast cancer continue to identify the need for better communication with physicians, studies to d ate have not investigated how the process of communication between physicia ns and women with breast cancer actually unfolds. This phenomenological stu dy therefore explored how women with breast cancer experience patient-physi cian communication to gain a greater understanding of effective approaches. Interviews of a purposeful sample of 11 women within 6 months of initial d iagnosis or recurrence of breast cancer were audiotaped, transcribed verbat im and analyzed using inductive interpretation. Themes and patterns of posi tive and negative experiences emerged. All experiences began with the woman 's feeling of vulnerability. In positive experiences, information sharing a nd relationship building were inextricably linked components of a working r elationship which was at the same time affective, behavioural and instrumen tal. This experience, in rum, influenced the woman's experience of control and mastery of the illness experience, and their experience of learning to live with breast cancer. Findings illuminate the importance of comprehensiv ely patient-centred, working relationships. Several specific techniques to enhance effective communication are identified. (C) 2000 Elsevier Science I reland Ltd. All rights reserved.