Understanding clinical communication about mood disturbance symptoms among breast cancer patients: A mixed methods analysis

Patient Educ Couns. 2022 Jul;105(7):2089-2095. doi: 10.1016/j.pec.2022.02.004. Epub 2022 Feb 10.


Objectives: We aimed to characterize the relationships between breast cancer patient mood symptom severity and demographic/medical factors with clinical communication about mood, and to explore mood discussion content.

Methods: 134 breast cancer patients (mean age=58.3; 14% minority; 13% metastatic) had oncology clinic visits audio-recorded, transcribed, and coded for mood communication. Patient Care Monitor assessed mood symptoms (anxiety/depression presence/severity). Logistic regressions measured associations between mood, demographic/medical factors, and communication. Thematic analysis characterized discussion topics.

Results: Over half of patients (55%; n = 73) reported mood symptoms. Worse mood symptoms were associated with younger age and current treatment (p's < 0.05). 19% of clinic visits (n = 26/134) contained mood discussions. Discussions were more common for younger women and those with non-metastatic disease (p's < 0.05). Odds of discussing mood increased with symptom severity (OR=4.52, p = 0.018). Cancer-related anxiety and medication management were among the most common topics discussed.

Conclusions: Communication about mood occurred infrequently, with women currently undergoing treatment, with metastatic disease, or with mild mood symptoms at potentially increased risk for inadequate discussion. Both patient-focused and provider-focused interventions to improve clinical communication about mood symptoms could be beneficial.

Practice implications: Clinicians hold a key role in supporting cancer patients' well-being by using and encouraging effective communication about patients' mood.

Keywords: Breast cancer; Clinical communication; Distress; Mood.

MeSH terms

  • Anxiety
  • Breast Neoplasms* / complications
  • Communication
  • Depression
  • Female
  • Humans
  • Middle Aged
  • Quality of Life