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Understanding clinical communication about mood disturbance symptoms among breast cancer patients: A mixed methods
Lauren A Zimmaro1, Kristen A Sorice1, Elizabeth A Handorf1
1Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
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.
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