Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Shi-Yi Wang

Second Advisor

Kerin Adelson

Abstract

Objectives. To examine breast cancer patient preferences in patient/provider communication methods during prognostic and treatment side effect conversations in an exploratory survey study.

Methods. A sample of 28 breast cancer patients receiving care from Yale New Haven Hospital Smilow Cancer Center completed an in-person, scenario-based survey between February-April 2022. Utilizing Smilow Cancer Center’s breast cancer repository, breast cancer patients who had a routine medical oncologist visit during the study period were recruited. Mann-Whitney U tests, univariate logistic regression, ordinal logistic regression, Wilcoxon Signed-Rank Tests, and qualitative analyses were utilized to determine patient preferences of communication methods that maximize patient understanding while minimizing patient stress, stratified by breast cancer stage.

Results. Statistical analyses supported the associations between higher breast cancer stages and preferences towards simplified conversation formats, and lower breast cancer stages and preferences towards detailed conversation formats. However, qualitative analyses and Signed-Rank Tests suggested that the incorporation of both simplified and detailed information was the most ideal format, regardless of a patient’s breast cancer stage. Quantitative analyses also supported the association between higher breast cancer stages and stress due to detailed conversation formats. This finding was also supported by qualitative analyses that identified detailed information as a potential source of patient stress.

Conclusion. Breast cancer stage may influence a patient’s preference for more simplified or detailed language during sensitive patient-provider conversations. Regardless of stage, participants noted the importance of a blended conversation that included both simplified and detailed information. Therefore, it may be optimal to ask a patient of their preferences before initiating a sensitive conversation.

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This is an Open Access Thesis.

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