The role of patient–provider communication for black women making decisions about breast cancer treatment

Sheppard, Vanessa B.; Adams, Inez; Lamdan, Ruth M.; Taylor, Kathryn L.

doi:10.1002/pon.1852

Cited by 59 publications

(53 citation statements)

References 51 publications

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“…20 The lack of association for grade and treatment was also not surprising; providers may not emphasize grade during treatment discussions as much as they may highlight subtype and stage. Although our observations are provocative and consistent with other work describing associations for understanding general treatment rationales and benefits of therapy with receipt of care, 5,6,8,28,29 broader interpretation of our results is limited by a lack of detailed information on treatment discussions, information on trastuzumab, patient preferences, and if/how information was conveyed to patients. In addition to the potential importance of individualized tumor information, others have suggested that the ways recurrence and survival risks are presented may also impact receipt of chemotherapy.…”

Section: Discussionsupporting

confidence: 87%

Association of Breast Cancer Knowledge With Receipt of Guideline-Recommended Breast Cancer Treatment

Freedman

Kouri

West

et al. 2016

JOP

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QUESTION ASKED: Is knowledge about one's cancer associated with treatment receipt for women with breast cancer?SUMMARY ANSWER: Knowledge about one's tumor characteristics was strongly associated with receipt of guideline-recommended therapies, suggesting the potential importance of knowledge about one's disease. METHODS:We surveyed women with stage I-III breast cancer diagnosed during 2010-2011. We assessed if reporting correct information about one's tumor, including stage, grade, estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) status, was associated with guideline-recommended chemotherapy, radiation, and hormonal therapy using the California Cancer Registry for confirmation of tumor information. RESULTS (OR WHAT WE FOUND):Among 414 women eligible for adjuvant therapies, patients who reported correct stage and HER2 status were more likely to receive chemotherapy than those reporting incorrect information. Those correctly reporting ER status were more likely than others to receive hormonal therapy and those reporting correct stage were also more likely to receive radiation (Fig). BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Although our observations are provocative, our results are limited by a lack of detailed information on treatment discussions, information on trastuzumab receipt, treatment adherence, patient preferences, and if/how information was conveyed to patients. Our definitions for correct information also relied on the accuracy of registry data. Finally, although knowledge about one's tumor was associated with receipt of therapy, whether a woman received treatment as a result of that knowledge or knew her tumor characteristics because she received treatment is uncertain. REAL-LIFE IMPLICATIONS:Our findings underscore the major knowledge deficits women had about their own cancers and suggest that this knowledge may be important in receipt of guidelinerecommended treatments. Our observations highlight the need for further study of the clinical, emotional, and social consequences of poor knowledge and how we can improve information delivery to patients. Interventions to improve patients' knowledge and understanding of their cancers should be tested as a strategy for improving cancer care. Abstract PurposeKnowledge about one's breast cancer characteristics is poor, but whether this knowledge affects treatment is uncertain. Among women with breast cancer, we examined whether tumor knowledge was associated with adjuvant treatment receipt. MethodsWe surveyed a population-based sample of women in Northern California with stage 0 to III breast cancer diagnosed during 2010 to 2011 (participation rate, 68.5%). Interviews were conducted between 4 months and 3 years after diagnosis. Among 414 respondents with stage I to III disease, we examined receipt of guideline-recommended chemotherapy, radiation, and hormonal therapy by reporting correct information about one's tumor, including stage, estrogen receptor, human epidermal growth factor receptor 2 (HER2), and grade (using registry data fo...

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Section: Discussionsupporting

confidence: 87%

Association of Breast Cancer Knowledge With Receipt of Guideline-Recommended Breast Cancer Treatment

Freedman

Kouri

West

et al. 2016

JOP

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“…Other selected measures were based on the adherence model of health behavior 25,26 and included sociodemographic, psychosocial, attitudinal, patient-provider interaction, health care setting, and clinical (surgery, American Joint Committee on Cancer [version 6] stage, and chemotherapy use) factors relevant to adherence to medication regimens. ( t n e m r i a p m i e v i t i n g o C ) 7 1 = n ( e l b i g i l e n i e g a t S ) 30 Patient perceptions of patient-physician communication were assessed using the Makoul scale and Primary Care Assessment Survey (PCAS).…”

Section: Methodsmentioning

confidence: 99%

Frailty and Adherence to Adjuvant Hormonal Therapy in Older Women With Breast Cancer: CALGB Protocol 369901

Sheppard

Faul

Luta

et al. 2014

JCO

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Purpose Most patients with breast cancer age ≥ 65 years (ie, older patients) are eligible for adjuvant hormonal therapy, but use is not universal. We examined the influence of frailty on hormonal therapy noninitiation and discontinuation. Patients and Methods A prospective cohort of 1,288 older women diagnosed with invasive, nonmetastatic breast cancer recruited from 78 sites from 2004 to 2011 were included (1,062 had estrogen receptor–positive tumors). Interviews were conducted at baseline, 6 months, and annually for up to 7 years to collect sociodemographic, health care, and psychosocial data. Hormonal initiation was defined from records and discontinuation from self-report. Baseline frailty was measured using a previously validated 35-item scale and grouped as prefrail or frail versus robust. Logistic regression and proportional hazards models were used to assess factors associated with noninitiation and discontinuation, respectively. Results Most women (76.4%) were robust. Noninitiation of hormonal therapy was low (14%), but in prefrail or frail (v robust) women the odds of noninitiation were 1.63 times as high (95% CI, 1.11 to 2.40; P = .013) after covariate adjustment. Nonwhites (v whites) had higher odds of noninitiation (odds ratio, 1.71; 95% CI, 1.04 to 2.80; P = .033) after covariate adjustment. Among initiators, the 5-year continuation probability was 48.5%. After adjustment, the risk of discontinuation was higher with increasing age (P = .005) and lower for stage ≥ IIB (v stage I) disease (P = .003). Conclusion Frailty is associated with noninitiation of hormonal therapy, but it does not seem to be a major predictor of early discontinuation in older patients.

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“…[31] Oysa sağlık personeli ile hasta arasındaki iletişimin yetersiz olması tedavi ile ilgili karar verme sürecini ve tedavinin sonuçlarını olumsuz etkileyebilir. [4] Hemşirelerin kanser hastalarına yeterli zamanı ayırmasına, hastalar ile iletişimlerini arttırmalarına gereksinim duyulmaktadır.…”

Section: Hastaların Sağlık Personelinin İletişimine Yönelik Değerlendunclassified

“…[4] Bu nedenle kanser hastalarının bilgi gereksinimlerini anlayabilmek için iletişim ve hastaların karar vermede desteklenmesi önemlidir. [5] Hastalar sağlık profesyonellerinden olumlu iletişim yanında bakım, destek [6] ve olayların anlayabilecekleri dilde anlatılmasını beklemektedirler.…”

Section: Introductionunclassified

Investigation of Cancer Patients’ Information Sources, Information Needs and Expectations of Health Professionals

BASKALE¹

2015

Psi Hem Derg

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ÖZETAmaç: Bu çalışmanın amacı kanser hastalarının bilgi kaynaklarını, bilgi gereksinimlerini ve sağlık personelinden beklentilerini incelemektir. Gereç ve Yöntem:Araştırma tanımlayıcı olarak yapılmıştır. Araştır-manın örneklemini Türkiye'de en sık kullanılan kanserle ilgili bir bloğun kullanıcıları olan, araştırmaya katılmayı kabul eden 120 kanser hastası oluşturmuştur. Veri toplama aracı olarak araştırmacılar tarafından literatüre dayalı olarak hazırlanan Hastaların Sağlık Personelinden Beklentileri isimli anket formu kullanılmıştır.Bulgular: Çalışmaya katılan kanser hastalarının %82.5'i hastalıkla ilgili bilgiyi doktordan, %70.8'i internetten almaktadır. Buna karşılık hastaların %97.5'i doktordan, %39.2'si hemşireden bilgi almak istemektedirler. Hastaların %45.8'i sağlık personelinin iletişimini kısmen yeterli, %35.0'i yetersiz, %19.2'si yeterli olarak belirtmiştir. Hastaların doktorlardan beklentileri; tedavi ve hastalık hakkında bilgi alma, anlayış, daha iyi bir iletişim kurması, duygusal destek alma, hastalık ve tedavi hakkında karar vermede destek olması, saygı göstermesi ve daha fazla zaman ayırması/dinlemesidir. Hastaların hemşirelerden beklentileri; anlayış, saygı, daha iyi bir iletişim kurması, bakımın daha iyi olması ve duygusal destek almadır. Hastalar sağlık personelinden tedavi ve yan etkileri, hastalığın tekrarlama ihtimali, hastalığın psikolojik durum üzerine etkileri, prognoz, tedavinin ne kadar süreceği ve hastalık (ne olduğu ve nedenleri) gibi konularda bilgi almak istemektedir.Sonuç: Sağlık personelinin hastalığın ve tedavinin her aşamasında hastayı bilgilendirmesi, dinlemesi, anlayışlı olması ve desteklemesi önemlidir. Ayrıca sağlık personeli hastalar tarafından kullanılan bilgi kaynaklarının farkında olmalıdır. Karmaşık tıbbi bilgiler, zor tedavi kararları almak, tedavinin yan etkileriyle mücadele etmek, hastalığın tekrarlama ve yaklaşan ölüm riski nedeniyle hastaların yaşam kaliteleri zamanla düşmektedir. [1] Bu zor süreçte hastaların sağlık profesyonellerinden beklentileri artmaktadır. Hastaların beklentileri arasında bilgi, yeterli iletişim, emosyonel destek ve bakım gelmektedir. [2] Kanser tanı ve tedavisi zorlu bir süreçtir ve bu süreçte hastalar ile sağlık profesyonelleri arasında iletişim problemleri yaşanabilmektedir. [3] Oysa sağlık profesyonelleri ile hasta arasındaki iletişimin yetersiz olması tedavi ile ilgili karar GirişKanser yaşamı önemli ölçüde etkileyen, zor bir hastalıktır.

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The role of patient–provider communication for black women making decisions about breast cancer treatment

Cited by 59 publications

References 51 publications

Association of Breast Cancer Knowledge With Receipt of Guideline-Recommended Breast Cancer Treatment

Association of Breast Cancer Knowledge With Receipt of Guideline-Recommended Breast Cancer Treatment

Frailty and Adherence to Adjuvant Hormonal Therapy in Older Women With Breast Cancer: CALGB Protocol 369901

Investigation of Cancer Patients’ Information Sources, Information Needs and Expectations of Health Professionals

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