PMID- 19514095
OWN - NLM
STAT- MEDLINE
DCOM- 20100903
LR  - 20220330
IS  - 1099-1611 (Electronic)
IS  - 1057-9249 (Linking)
VI  - 19
IP  - 6
DP  - 2010 Jun
TI  - Behind closed doors: systematic analysis of breast cancer consultation 
      communication and predictors of satisfaction with communication.
PG  - 626-36
LID - 10.1002/pon.1592 [doi]
AB  - OBJECTIVE: The purpose of this investigation was to explicate the content of 
      primary adjuvant treatment consultations in breast oncology and examine the 
      predictive relationships between patient and oncologist consultation factors and 
      patient satisfaction with communication. METHODS: The recorded consultations of 
      172 newly diagnosed breast cancer patients from four Canadian cancer centers were 
      randomly drawn from a larger subset of 481 recordings and examined by three 
      coders using the Medical Interaction Process System (MIPS); a system that 
      categorizes the content and mode of each distinct utterance. The MIPS findings, 
      independent observer ratings of patient and oncologist affective behavior, and 
      derived consultation ratios of patient centeredness, patient directedness, and 
      psychosocial focus, were used to predict patient satisfaction with communication 
      post-consultation and at 12-weeks post-consultation. RESULTS: Biomedical content 
      categories were predominant in the consultations, accounting for 88% of all 
      utterances, followed by administrative (6%) and psychosocial (6%) utterances. 
      Post-consultation satisfaction with communication was significantly higher for 
      older patients, those with smaller primary tumors and those with longer 
      consultations. Smaller tumor, lack of patient assertiveness during the treatment 
      consultation and having the consultation with a radiation rather than medical 
      oncologist were significantly predictive of greater satisfaction at 12-weeks 
      post-consultation. CONCLUSIONS: Adjuvant treatment consultations are 
      characterized by a high degree of information-giving by the physician, a 
      predominance of biomedical discussion and relatively minimal time addressing 
      patients' psychosocial concerns. Controlled trials are needed to further identify 
      and address the contextual features of these consultations that enhance patient 
      satisfaction.
CI  - (c) 2009 John Wiley & Sons, Ltd.
FAU - Hack, Thomas F
AU  - Hack TF
AD  - Faculty of Nursing, University of Manitoba, Winnipeg, MB, Canada. thack@sbrc.ca
FAU - Pickles, Tom
AU  - Pickles T
FAU - Ruether, J Dean
AU  - Ruether JD
FAU - Weir, Lorna
AU  - Weir L
FAU - Bultz, Barry D
AU  - Bultz BD
FAU - Degner, Lesley F
AU  - Degner LF
LA  - eng
GR  - Canadian Institutes of Health Research/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Psychooncology
JT  - Psycho-oncology
JID - 9214524
SB  - IM
MH  - Breast Neoplasms/*psychology/therapy
MH  - *Communication
MH  - Female
MH  - Humans
MH  - Medical Oncology/standards
MH  - Middle Aged
MH  - Patient Education as Topic
MH  - Patient Satisfaction
MH  - *Physician-Patient Relations
MH  - Referral and Consultation/standards
EDAT- 2009/06/11 09:00
MHDA- 2010/09/04 06:00
CRDT- 2009/06/11 09:00
PHST- 2009/06/11 09:00 [entrez]
PHST- 2009/06/11 09:00 [pubmed]
PHST- 2010/09/04 06:00 [medline]
AID - 10.1002/pon.1592 [doi]
PST - ppublish
SO  - Psychooncology. 2010 Jun;19(6):626-36. doi: 10.1002/pon.1592.