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ABSTRACT: Physician-patient interaction at breast cancer diagnosis can only succeed if physicians know what patients want. To investigate patients' needs and experiences we conducted semistructured interviews with eight patients. Verbatim transcripts were analyzed according to grounded theory and a typological approach. Patients' needs and experiences concurred with a patient-centered approach in many aspects. The threat perceived by patients following diagnosis strongly influenced their needs and experiences. Three different types of patients were identified: emotionally needy, active, and trustful, adaptive. The typology identified in this study may help physicians to adequately adapt their behavior.
Journal of Psychosocial Oncology 03/2010; 28(2):157-72. · 0.98 Impact Factor
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ABSTRACT: This study explored the impact of breast cancer patients' experiences of physician-patient communication and participation in decision making on patient depression and quality of life three and six months after primary treatment.
Participants were 135 German breast cancer patients, recruited within a week after the beginning of treatment. Women were asked to complete a self-administered questionnaire at baseline and three and six months later.
Patients who rated their level of information at baseline as high were less depressed after three (p=.010) and six months (p<.001) and experienced higher quality of life after three (p<.001) and six months (p=.049). Patients who participated as much as they had wanted were more satisfied with the decision making process (p<.001) and had lower depression scores three months later (p=.005). The level of participation itself (passive, collaborative, active) and the treatment type had no impact.
The findings reveal the significance of physician-patient communication and stress the meaning of baseline depression for later adjustment.
A high level of information and tailoring the involvement in decision making to patients' desired level can help patients to better cope with their illness. Physicians should assess and treat depression early in cancer treatment.
Patient Education and Counseling 09/2009; 77(3):391-7. · 2.31 Impact Factor
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ABSTRACT: This study explored breast cancer patients' preferences and experiences in receiving information and decision making in the course of the first 6 months of cancer treatment.
Participants were 135 German breast cancer patients, recruited within a week of either surgery or the beginning of neo-adjuvant chemotherapy. Women were asked to complete a self-explanatory questionnaire at baseline and 3 and 6 months later.
There was a significant decrease in the importance of specific information needs. The quality of received information through the physician was rated significantly better at baseline than 6 months later. Nearly half of all patients changed their decision making preference at least at one assessment point. Shared decision making rarely took place in the first 6 months of treatment.
Breast cancer patients' information needs and decision making preferences can change during treatment. Future research should analyse which patients change their decision making preference under which circumstances.
Physicians need to investigate the decision making preferences and information needs of their patients in the course of treatment. Patient oriented communication skills might be helpful to meet patients' preferences and needs.
Patient Education and Counseling 05/2008; 71(1):79-85. · 2.31 Impact Factor
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ABSTRACT: This study explored breast cancer patients' preferences and experiences for participation in treatment decision making as well as the concordance between patients' actual and desired decision making. The interplay between depression, anxiety and decision-making preferences was also examined.A consecutive sample of primary breast cancer patients was recruited within a week of either surgery or the beginning of neo-adjuvant chemotherapy in two breast cancer centres in Germany. Women were asked to complete a self-explanatory questionnaire. Most patients (40.2%) of the 137 participants preferred the physician to make the treatment decision. A total of 63.4% were able to fulfil their preferred decision-making role. Breast cancer patients who wanted the physician to make the decision and patients who wanted to make the decision on their own were more likely to have their preferences met than patients who wished to share the decision (p < 0.01). Availability of treatment choice and the level of depression influenced the preferred decision-making preference. Limited concordance between desired and actual decision making of patients with collaborative decision-making preferences suggests the need for better communication and physician training on shared decision making.
Psycho-Oncology 02/2008; 17(2):182-9. · 3.34 Impact Factor
