175854 Relationship between Patient-Physician Communication and Emotional Health Outcomes in Cancer Patients

Monday, October 27, 2008

Chien-Ching Li, MS MPH , School of Public Health, Ph.D Program in Health Service Research, Saint Louis University, St. Louis, MO
Naoko Muramatsu, PhD , Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL
Alicia Matthews, PhD , Department of Public Health, Mental Health, and Administrative Nursing, University of Illinois at Chicago, Chicago, IL
Introduction: The diagnosis of cancer typically evokes uncertainty and loss of control among patients. Furthermore, the fear associated with a cancer diagnosis, the complexity of medical information, and uncertainty regarding the course of the disease and treatment adds an emotional dimension to the patient-physician interaction.

Objective: To understand how patient-physician communication would influence cancer patients' emotional health outcomes and psychological distress at various stages of cancer from diagnosis to treatment.

Data sources: Of more than 60 articles identified through PubMed using the medical subject heading (MeSH) "Physician-Patient Relations", "Neoplasm", "Communication", "Anxiety", “Depression” and “Quality of Life”. A total of 12 articles focused on disclosure of diagnosis, physician's communication styles, and treatment choices were selected.

Results: Patient-physician communication would significantly affect cancer patients' emotional health outcomes. At the stage of disclosure of diagnosis, certain physicians' characteristics (e.g. appearing nervous) could reduce the level of hopefulness among their patients. Physicians' communication styles, perceived by patients as attentive, empathetic, compassionate, and patient-centered, would reduce emotional distress and anxiety, while those perceived as angry or irritated would increase psychological distress. When it comes to treatment decisions related to breast cancer, patients were less anxious and depressed if physicians offered the choice of surgery.

Conclusion: Patients who were given the opportunity to participate in decision-making experienced significantly greater decrease in anxiety. Evidence also indicates that when patients' preferred level of participation in treatment decision making did not match with their perceived role in actual decision making, their anxiety level increased after consulting with their physicians.

Learning Objectives:
1. Identify the impacts of patient-physician communication on cancer patients' emotional health outcomes. 2. Describe how patient-physician communication affects caner patients’ mental health from disclosure of diagnosis to treatment stage.

Keywords: Cancer, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This is my Master paper
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.