The Surgeon-Patient Interaction in Older Women With Breast Cancer: What Are the Determinants of a Helpful Discussion?
Surgery is a key modality in the treatment of breast cancer. The patient-physician interaction is a key determinant of a range of outcomes, but there is little work examining the surgeon–breast cancer patient interaction. We analyzed data from 240 women with a new breast cancer diagnosis to better understand this interaction and to delineate the patient, surgeon, and surgeon-patient interaction-level characteristics affecting this interaction.
A cross-sectional survey was conducted in Los Angeles County of 240 women with a new breast cancer diagnosis aged ≥55 years. Women were asked to rate on a scale of 0 to 10 how helpful overall the way their surgeon discussed their breast cancer with them was. Logistic regression models were constructed to assess the relationship of patient, surgeon, and surgeon-patient interaction characteristics to the outcome variable.
Forty-four percent of women said that they found the way their surgeon discussed their breast cancer with them extremely helpful. Women with a higher level of perceived self-efficacy, a longer consultation time with the surgeon, a higher interactive information-giving score, and a higher participatory decision-making score had significantly higher odds of reporting the discussion to be “extremely helpful.”
Our results indicate that strategies to improve the patient’s perceived self-efficacy (preparing questions beforehand, practicing, watching a role model, and so on) will improve the surgeon-patient discussion. At a systems level, adequate time should be budgeted for the consultation, and we must ensure that adequate communication skills are imparted to surgeons during their educational training.
KeywordsBreast cancer Surgeon-patient interaction Helpful discussion Older women
- 18.National Center for Health Statistics. Physician office visit data. Available at: http://www.cdc.gov/nchs/about/major/ahcd/officevisitcharts.htm. Accessed: March 14, 2005
- 22.National Cancer Policy Board. Ensuring Quality Cancer Care. Washington, DC: National Academy Press, 1999Google Scholar
- 36.Neisser U, Hyman IE. Memory Observed: Remembering in Natural Contexts. 2nd ed. New York: Worth Publishers, 2000Google Scholar