Communication about Sexual Health in Breast Cancer: What Can We Learn from Patients' Self-Report and Clinic Dialogue?

Patient Educ Couns. 2020 Sep;103(9):1821-1829. doi: 10.1016/j.pec.2020.03.029. Epub 2020 Apr 4.

Abstract

Objective: Research assessing clinical communication about sexual health is limited. We compared clinical communication about sexual health across patients' self-reports and coded dialogue in breast cancer outpatients.

Methods: 134 patients had clinic visits audio-recorded and coded for sexual health communication and completed self-report questionnaires immediately after the visit. Associations between the self-report and dialogue were assessed using Phi coefficient. Agreements (present/absent) and discrepancies (omissions, commissions) about discussed topics were classified and discrepancies analyzed for themes.

Results: Sexual health was discussed in 61 of 134 patient visits (46%). Associations were significant (p < .01) but differed by topic (φ = .27-.76). 37 women (23%) had ≥ 1 self-report error. Discrepancies were common (19 omissions, 29 commissions). Patients often omitted communication about sexual concerns when such concerns were not problematic, and interpreted non-specific discussions as including specific topics of concern, even when not explicitly stated. Omissions were more common for women with lower education.

Conclusions: Patients' reports of whether sexual health communication occurs does not always align with observed dialogue, and may vary by personal relevance of the topic.

Practice implications: There are limitations in determining the prevalence of clinical communication about sexual health through patient self-report. Explaining sexual health terms might enhance shared understanding.

Keywords: Breast Cancer; Communication; Dialogue Analysis; Sexual Health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ambulatory Care Facilities
  • Breast Neoplasms / complications
  • Breast Neoplasms / psychology*
  • Communication*
  • Female
  • Health Communication
  • Humans
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Qualitative Research
  • Quality of Life / psychology*
  • Self Report
  • Sexual Behavior / psychology*
  • Sexual Health*
  • Sexual Partners*
  • Surveys and Questionnaires