Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA.
Patient Educ Couns. 2022 Jul;105(7):2089-2095. doi: 10.1016/j.pec.2022.02.004. Epub 2022 Feb 10.
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.
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.
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.
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.
Clinicians hold a key role in supporting cancer patients' well-being by using and encouraging effective communication about patients' mood.
我们旨在描述乳腺癌患者情绪症状严重程度与情绪临床沟通相关的人口统计学/医学因素之间的关系，并探讨情绪讨论的内容。
134 名乳腺癌患者（平均年龄=58.3；14%为少数民族；13%为转移性疾病）的肿瘤临床就诊进行了录音、转录和情绪沟通编码。患者护理监测评估情绪症状（焦虑/抑郁的存在/严重程度）。逻辑回归测量了情绪、人口统计学/医学因素与沟通之间的关联。主题分析描述了讨论的主题。
超过一半的患者（55%；n=73）报告了情绪症状。情绪症状越严重，与年龄越小和当前治疗有关（p 值均<0.05）。19%的临床就诊（n=134 例中的 26 例）包含情绪讨论。年轻女性和非转移性疾病患者的讨论更为常见（p 值均<0.05）。讨论情绪的可能性随症状严重程度增加（OR=4.52，p=0.018）而增加。癌症相关焦虑和药物管理是讨论最多的话题之一。
关于情绪的沟通很少发生，正在接受治疗、患有转移性疾病或情绪症状轻微的女性可能存在沟通不足的风险。针对患者和提供者的干预措施，以改善关于情绪症状的临床沟通，可能会有所帮助。
临床医生通过使用和鼓励有效的关于患者情绪的沟通，在支持癌症患者的幸福感方面发挥着关键作用。
