Do Health Care Professionals Discuss the Emotional Impact of Cancer with Patients?

Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
Psycho-Oncology (Impact Factor: 2.44). 09/2013; 22(9). DOI: 10.1002/pon.3258
Source: PubMed


It is known that cancer may affect patients' emotions and their relationships with other people and that those with strong emotional support may enjoy improved outcomes. We sought to determine the frequency with which healthcare professionals discuss the impact of cancer on patients' emotions and relationships with others.

Data regarding healthcare professionals' discussions of the emotional impact of cancer and relevant covariates were obtained from the 2010 National Health Interview Survey. Statistical analyses were performed using sudaan software (Research Triangle Institute, Raleigh, NC, USA).

Of the 2074 people with a prior diagnosis of cancer surveyed, 701 (33.8%) claimed that a doctor, nurse, or other healthcare professional had discussed with them 'how cancer could affect their emotions or relationships with others'. Of these, 586 (84.5%) reported that they were 'very satisfied' with how well their emotional and social needs were met; 73.4% of those who had not had this discussion reported being very satisfied. Patients with leukemia/lymphoma, younger patients, African Americans, and those with a lower degree of education were most likely to report having discussions about emotional issues. Gender was not correlated with these discussions (30.6% in men vs. 33.3% in women). On multivariate analysis, age, race, and cancer type remained independent significant predictors of having a discussion regarding the emotional impact of cancer.

Only a third of cancer patients discussed the emotional impact of a cancer diagnosis with their healthcare professional. Age, race, and type of malignancy affect the likelihood of having these discussions.

21 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Guidance encourages oncologists to engage patients and relatives in discussing the emotions that accompany cancer diagnosis and treatment. We investigated the perspectives of parents of children with leukaemia on the role of paediatric oncologists in such discussion. Methods: Qualitative study comprising 33 audio-recorded parent–oncologist consultations and semi-structured interviews with 67 parents during the year following diagnosis. Results: Consultations soon after the diagnosis were largely devoid of overt discussion of parental emotion. Interviewed parents did not describe a need for such discussion. They spoke of being comforted by oncologists' clinical focus, by the biomedical information they provided and by their calmness and constancy. When we explicitly asked parents 1 year later about the oncologists' role in emotional support, they overwhelmingly told us that they did not want to discuss their feelings with oncologists. They wanted to preserve the oncologists' focus on their child's clinical care, deprecated anything that diverted from this and spoke of the value of boundaries in the parent–oncologist relationship. Conclusion: Parents were usually comforted by oncologists, but this was not achieved in the way suggested by communication guidance. Communication guidance would benefit from an enhanced understanding of how emotional support is experienced by those who rely on it.
    British Journal of Cancer 07/2013; 109(4). DOI:10.1038/bjc.2013.413 · 4.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Helplines are core feature of the contemporary UK healthcare system, however little is known about callers' experiences of seeking cancer-related telephone help. Qualitative interviews were conducted with 32 cancer helpline callers. The findings suggest cancer helplines offer callers (1) time to discuss their issues; (2) anonymity; (3) convenience; and (4) an open outlet for anyone affected by cancer including family/friends. Further, the findings highlighted that callers' help-seeking behaviour was multi-faceted, with their psychosocial needs being intrinsically intertwined with their information or advice-seeking needs. The implications are discussed in relation to the role of cancer helplines in the healthcare system.
    Journal of Psychosocial Oncology 03/2014; 32(3). DOI:10.1080/07347332.2014.897294 · 1.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Distress is a common and clinically relevant complication of breast cancer which can occur at any time. Several organizations have recommended systematic screening for distress but, because there is still a debate about its effectiveness, uptake has been slow. Screening research can be divided into studies of diagnostic validity that test the accuracy of particular tools and studies involving screening implementation that test the clinical success of screening. Despite many cross-sectional validation studies, few have specifically studied breast cancer patients. Only one short tool, the distress thermometer (DT), and a longer tool, the hospital anxiety and depression scale (HADS) have been evaluated in both types of study in more than one centre. Multidomain tools, for example the Edmonton symptom assessment system (ESAS) and the Emotion Thermometer (ET), are promising, and are currently under evaluation. Current evidence suggests that for any mental disorder (including adjustment disorder) the DT has sensitivity of 84 % and specificity of 63 % and the HADS has sensitivity of 65 % and specificity of 77 %. Evidence to date suggests that the DT and HADS are moderately accurate when helping identify distress, performing best in screening (initial assessment), but only slightly increase referrals for psychosocial care. However, their effect can be magnified by combining screening with mandatory follow-up.
    Current Breast Cancer Reports 09/2014; 6(3):226-234. DOI:10.1007/s12609-014-0157-9