Understanding clinical communication about mood disturbance symptoms among breast cancer patients: A mixed methods analysis.
Lauren A Zimmaro, Kristen A Sorice, Elizabeth A Handorf and 2 others
PMID 35184908WHAT IT FOUND
Mood symptoms were reported by 54.5% of breast cancer patients, but mood was discussed in only 19% of clinic visits.
Women with moderate or severe symptoms were more likely to have mood discussed; those with mild symptoms were not.
Key findings
01Mood was discussed in 19% of recorded clinic visits, and patients initiated 57.7% of those discussions.
02Mood discussion occurred in 43% of visits for women with moderate or severe symptoms, 14% for mild symptoms, and 8% for no symptoms; mild symptoms were not more likely to be discussed than no symptoms.
03When mood was discussed, anxiety was the most common symptom described (50%), and pharmacological management was the most common clinician intervention (62%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample came from one cancer center and was mostly white, so the findings may not apply to other groups. Mood symptoms were measured with single items, not full anxiety or depression scales, so clinically diagnosed mood disorders were not assessed. The study did not know whether patients were already receiving mental health care outside the oncology visit, so lack of mood discussion could mean care was happening elsewhere. The recordings were collected as part of a pilot trial of a sexual health communication intervention, so the visits may not represent routine oncology practice. The study did not assess whether patients completed a distress thermometer or whether clinicians reviewed it before the visit. Only 26 of 134 visits included mood discussion, so the qualitative themes are based on a small subset of encounters.
Declared interests
The authors declared no competing financial interests or personal relationships. The article lists non-U.S. government and N.I.H. extramural research support.
The easy way to misread this
Do not conclude that breast cancer patients have few mood concerns because mood was discussed in only 19% of visits. Patients reported mood symptoms in 54.5% of cases, and mild symptoms were not more likely to be discussed than no symptoms.