2.50
Hdl Handle:
http://hdl.handle.net/10755/158028
Type:
Presentation
Title:
Communication with Breast Cancer Survivors
Abstract:
Communication with Breast Cancer Survivors
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:Clayton, Margaret, PhD, RN, FNP-CS
P.I. Institution Name:University of Utah
Title:Assistant Professor
Contact Address:4112 S 3305 E, Salt Lake City, UT, 84124, USA
Contact Telephone:801-585-5372
Co-Authors:William Dudley, PhD; and Adrian Musters
Background: An increase in breast cancer survivorship has resulted in women managing the long-term side effects and symptoms of breast cancer treatment, requiring communication about both biomedical and contextual factors. Yet both survivors and providers frequently report frustration with the communication process. Additionally, little is known about the communication practices of non-physician providers.
Purpose: The purpose of this exploratory cross-sectional study was to explore how patient-centered communication influenced survivor uncertainty, mood state, and survivor perception of patient-centered communication for women with varying fatigue levels. Sample: Sixty recurrence-free breast cancer survivors 2 or more years post-treatment were recruited (26% African American, 74% Caucasian; mean age 61.7, sd 11.3; mean educational level 13.3, sd 2.4). Ninety-eight percent had surgical treatment usually combined with chemotherapy, radiation or both. Six providers (3 oncologists, two physician assistants, and 1 nurse practitioner) were also recruited. Four providers were female, two were male.
Methods: A conceptual model was developed using Uncertainty in Illness Theory, and the theoretical dimensions of a patient-centered relationship. Fatigue was selected as the target symptom due to its prevalence, uncertainty about its cause, and complexity of causal factors requiring conversation about biomedical as well as contextual concerns (i.e. patient-centered communication). Women were consented, then screened for fatigue prior to their office visit. Visits were audio-taped, then post visit measures completed. Results: Audio-taped communication was coded using the Measure of Patient-Centered Communication verbal coding scheme, allowing both qualitative and quantitative analysis of conversation. Total patient-centered scores ranged from 26-87; higher scores indicate more patient-centered communication. The dimension of exploring symptoms had the lowest amount of patient-centered communication, with contextual and planning components respectively higher. Exploration by provider type showed that nurse practitioners and physician assistants had higher patient-centered communication scores than oncologists. The model was tested using Chi-square Automatic Interaction Detection (CHAID) to identify predictors of uncertainty, mood state, and survivor perception of patient-centered communication. Overall, fatigue level was the best predictor of uncertainty, mood state, and survivor perception of patient-centered communication. The best communication predictor of outcomes was exploration of symptoms, especially for those reporting lower levels of fatigue. Content analysis of visits showed that only 58% of women mentioned fatigue, yet there was no difference in fatigue between those who did and those who did not mention fatigue (t 1.06; df 53; p 0.29). Conclusions: Fatigue remains an important symptom to address during consultations with breast cancer survivors, and remains unaddressed in a large percentage of women. Communication results show that, irrespective of fatigue level and actual amount of patient-centered communication (determined by verbal coding scores), conversation about symptoms was most influential in predicting survivor outcomes. The present study suggests that women may assign more importance to communication involving provider exploration of symptoms, than for discussion with providers about symptom management within the context of the work or home environment. One explanation may be an underlying fear of recurrence, known to be prevalent in breast cancer survivors and triggered by events such as office visits. Results also indicate a need for further exploration of the relationship between provider characteristics and communication. Funding: 1. American Nurses Foundation: 2004 Jean E. Johnson, RN Scholar; 2. Post Doctoral Fellowship; T-32 Institutional National Research Service Award: Interventions for Preventing and Managing Chronic Illness. NIH - NINR T-32 NR07091, UNC-CH School of Nursing.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCommunication with Breast Cancer Survivorsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158028-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Communication with Breast Cancer Survivors</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Clayton, Margaret, PhD, RN, FNP-CS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Utah</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">4112 S 3305 E, Salt Lake City, UT, 84124, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">801-585-5372</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">margaret.clayton@nurs.utah.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">William Dudley, PhD; and Adrian Musters</td></tr><tr><td colspan="2" class="item-abstract">Background: An increase in breast cancer survivorship has resulted in women managing the long-term side effects and symptoms of breast cancer treatment, requiring communication about both biomedical and contextual factors. Yet both survivors and providers frequently report frustration with the communication process. Additionally, little is known about the communication practices of non-physician providers. <br/>Purpose: The purpose of this exploratory cross-sectional study was to explore how patient-centered communication influenced survivor uncertainty, mood state, and survivor perception of patient-centered communication for women with varying fatigue levels. Sample: Sixty recurrence-free breast cancer survivors 2 or more years post-treatment were recruited (26% African American, 74% Caucasian; mean age 61.7, sd 11.3; mean educational level 13.3, sd 2.4). Ninety-eight percent had surgical treatment usually combined with chemotherapy, radiation or both. Six providers (3 oncologists, two physician assistants, and 1 nurse practitioner) were also recruited. Four providers were female, two were male.<br/>Methods: A conceptual model was developed using Uncertainty in Illness Theory, and the theoretical dimensions of a patient-centered relationship. Fatigue was selected as the target symptom due to its prevalence, uncertainty about its cause, and complexity of causal factors requiring conversation about biomedical as well as contextual concerns (i.e. patient-centered communication). Women were consented, then screened for fatigue prior to their office visit. Visits were audio-taped, then post visit measures completed. Results: Audio-taped communication was coded using the Measure of Patient-Centered Communication verbal coding scheme, allowing both qualitative and quantitative analysis of conversation. Total patient-centered scores ranged from 26-87; higher scores indicate more patient-centered communication. The dimension of exploring symptoms had the lowest amount of patient-centered communication, with contextual and planning components respectively higher. Exploration by provider type showed that nurse practitioners and physician assistants had higher patient-centered communication scores than oncologists. The model was tested using Chi-square Automatic Interaction Detection (CHAID) to identify predictors of uncertainty, mood state, and survivor perception of patient-centered communication. Overall, fatigue level was the best predictor of uncertainty, mood state, and survivor perception of patient-centered communication. The best communication predictor of outcomes was exploration of symptoms, especially for those reporting lower levels of fatigue. Content analysis of visits showed that only 58% of women mentioned fatigue, yet there was no difference in fatigue between those who did and those who did not mention fatigue (t 1.06; df 53; p 0.29). Conclusions: Fatigue remains an important symptom to address during consultations with breast cancer survivors, and remains unaddressed in a large percentage of women. Communication results show that, irrespective of fatigue level and actual amount of patient-centered communication (determined by verbal coding scores), conversation about symptoms was most influential in predicting survivor outcomes. The present study suggests that women may assign more importance to communication involving provider exploration of symptoms, than for discussion with providers about symptom management within the context of the work or home environment. One explanation may be an underlying fear of recurrence, known to be prevalent in breast cancer survivors and triggered by events such as office visits. Results also indicate a need for further exploration of the relationship between provider characteristics and communication. Funding: 1. American Nurses Foundation: 2004 Jean E. Johnson, RN Scholar; 2. Post Doctoral Fellowship; T-32 Institutional National Research Service Award: Interventions for Preventing and Managing Chronic Illness. NIH - NINR T-32 NR07091, UNC-CH School of Nursing.</td></tr></table>en_GB
dc.date.available2011-10-26T20:26:17Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:26:17Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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