Communication about Sexual Health in Breast Cancer: What Can We Learn from Patients’ Self-Report and Clinic Dialogue?

Objective: 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. Methods: 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. Results: 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. Conclusions: Patients’ reports of whether sexual health communication occurs does not always align with observed dialogue, and may vary by personal relevance of the topic. Practice Implications: 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.