Communication about Sexual Health in Breast Cancer: What Can We Learn from Patients' Self-Report and Clinic Dialogue?
Jennifer Barsky Reese, Kristen A Sorice, Lauren A Zimmaro and 2 others
PMID 32349896WHAT IT FOUND
Questionnaires from 134 breast cancer visits did not match what was said in the room in 37 cases.
Some patients missed sexual health talk that happened; some reported topics not explicitly discussed. Talk felt irrelevant was forgotten, and broad questions were read as specific concerns.
Key findings
01Sexual health topics were observed in 61 of 134 patient visits, most often vaginal dryness or discomfort in 37 visits.
0237 women had discrepancies between their questionnaire and the recorded dialogue: 16 did not report a topic that was discussed, and 21 reported a topic that was not observed.
03Some omissions happened when clinicians raised a topic and the patient said it was not a problem; some commissions happened when clinicians used non-specific sexual health language.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis came from a pilot trial at a single urban cancer centre, and most patients were white, married or partnered, college graduates, early stage breast cancer, and post-treatment. Few women had metastatic disease, and the sample had limited racial and ethnic diversity, so results may not apply to more diverse or advanced disease populations. The questionnaire used single yes or no items for each topic, which can be less accurate than multiple items. The body image code focused on breast appearance, so patients who discussed hair loss or weight gain as body image were counted as commissions. The subsample with lower education was small. This analysis compared assessment methods; it did not report outcomes of the communication intervention. Orgasm was not discussed in any visit, so findings about that topic are limited to patient false reports.
Declared interests
No conflict of interest was declared.
The easy way to misread this
Do not treat a patient's post-visit questionnaire as a complete record of what was said in the clinic. In 134 visits, 37 women had discrepancies, and some reported topics that were not observed while others did not report topics that were discussed.