Understanding clinical communication about mood disturbance symptoms among breast cancer patients: A mixed methods analysis

Lauren A. Zimmaro, Kristen A. Sorice, Elizabeth A. Handorf, Mary B. Daly, Jennifer B. Reese

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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. Practice implications: Clinicians hold a key role in supporting cancer patients’ well-being by using and encouraging effective communication about patients’ mood.

Original languageEnglish
Pages (from-to)2089-2095
Number of pages7
JournalPatient Education and Counseling
Volume105
Issue number7
DOIs
StatePublished - Jul 2022

Keywords

  • Breast cancer
  • Clinical communication
  • Distress
  • Mood

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