Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA; Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA.
Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
Patient Educ Couns. 2020 Sep;103(9):1821-1829. doi: 10.1016/j.pec.2020.03.029. Epub 2020 Apr 4.
Research assessing clinical communication about sexual health is limited. We compared clinical communication about sexual health across patients' self-reports and coded dialogue in breast cancer outpatients.
134 patients had clinic visits audio-recorded and coded for sexual health communication and completed self-report questionnaires immediately after the visit. Associations between the self-report and dialogue were assessed using Phi coefficient. Agreements (present/absent) and discrepancies (omissions, commissions) about discussed topics were classified and discrepancies analyzed for themes.
Sexual health was discussed in 61 of 134 patient visits (46%). Associations were significant (p < .01) but differed by topic (φ = .27-.76). 37 women (23%) had ≥ 1 self-report error. Discrepancies were common (19 omissions, 29 commissions). Patients often omitted communication about sexual concerns when such concerns were not problematic, and interpreted non-specific discussions as including specific topics of concern, even when not explicitly stated. Omissions were more common for women with lower education.
Patients' reports of whether sexual health communication occurs does not always align with observed dialogue, and may vary by personal relevance of the topic.
There are limitations in determining the prevalence of clinical communication about sexual health through patient self-report. Explaining sexual health terms might enhance shared understanding.
评估有关性健康的临床沟通的研究有限。我们比较了乳腺癌门诊患者的自我报告和编码对话中的性健康沟通。
134 名患者的就诊进行了录音和编码，以进行性健康沟通，并在就诊后立即完成自我报告问卷。使用 Phi 系数评估自我报告和对话之间的关联。将讨论主题的存在/不存在（出现/未出现）和差异（遗漏、遗漏）进行分类，并对差异进行主题分析。
在 134 次就诊中有 61 次（46%）讨论了性健康问题。关联具有统计学意义（p<0.01），但因主题而异（φ=0.27-0.76）。37 名女性（23%）有≥1 次自我报告错误。差异很常见（19 次遗漏，29 次遗漏）。当性问题不严重时，患者通常会遗漏有关性问题的沟通，并且即使没有明确说明，也会将非特定的讨论解释为包括特定关注的主题。教育程度较低的女性遗漏的情况更为常见。
患者是否发生性健康沟通的报告并不总是与观察到的对话一致，并且可能因主题的个人相关性而异。
通过患者自我报告来确定临床沟通中有关性健康的普遍性存在局限性。解释性健康术语可能会增强共同理解。
