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Patient Educ Couns. 2014 Nov;97(2):165-72. doi: 10.1016/j.pec.2014.07.020. Epub 2014 Jul 22.

What to listen for in the consultation. Breast cancer patients' own focus on talking about acceptance-based psychological coping predicts decreased psychological distress and depression.

Author information

1
Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Dep. 6931, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: cgjensen@nru.dk.
2
Center for Humanistic Health Research, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
3
Herlev Hospital, Herlev, Denmark.
4
Ringsted Hospital, Ringsted, Denmark.
5
Department of Psychosocial Cancer Research at the Institute of Cancer Epidemiology, The Danish Cancer Society (EPI), Copenhagen, Denmark.

Abstract

OBJECTIVE:

To analyze whether qualitative themes in breast cancer patients' self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process.

METHODS:

Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression scale (CES-D).

RESULTS:

Among the qualitative themes, only the percentage of words spent on talking about 'Acceptance-based psychological coping' was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted less psychological distress and depression, respectively. A cross-validation including only the first few minutes of speech per patient confirmed these results and supported their practical utility in health consultations.

CONCLUSION:

Patients' focus on acceptance-based coping significantly predicted decreased psychological distress and depression, respectively. No other qualitative themes predicted symptoms. Doctor-patient studies may benefit from combined qualitative-quantitative methods.

PRACTICE IMPLICATIONS:

While quantitative symptom assessment is important for a consultation, health care providers may improve their understanding of patients by attending to patients' presentations of acceptance-based psychological coping.

KEYWORDS:

Cancer; Consultation; Coping; Illness perception; Mindfulness; Mixed methods; Self-presentation

PMID:
25086446
DOI:
10.1016/j.pec.2014.07.020
[Indexed for MEDLINE]

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