Emotional talk of patients with breast cancer during review appointments with therapeutic radiographers: effects on fears of cancer recurrence

Abstract

Fears of cancer recurrence (FCR) in patients with breast cancer may develop during radiotherapy. Radiographer communication with their patients may influence early survivorship FCR level. Aim To investigate the management of emotional talk in patients with breast cancer attending their initial review appointments during radiotherapy and predict FCR at 6-8 weeks follow-up. Methods A mixed methods observational study was conducted. Patients (consecutive sample, n = 60) with breast cancer, attending a major Scottish cancer centre, had their first two review appointments with their therapeutic radiographer (TR) audio-recorded. In addition, FCR was assessed (FCR7) at baseline and at 6-8 weeks following their final radiotherapy visit. Two TRs participated. Audio-files were coded by the VR-CoDES system to identify emotional cues and therapeutic radiographer (TR) responses. Linear regression models were tested for fit and to identify factors associated with follow-up FCR, i.e. patient cues, responses by TR. Results Follow-up FCR was predicted negatively (robust estimator, p = .01) by level of patient emotional talk at the second review session. The provision of space by the TR, at the second session, to enable patients to expand their emotional utterances was also associated, but negatively (p = .01), with follow-up FCR. These effects were maintained after inclusion of covariates: age, treatment received and living conditions. Conclusions Patient's emotional expression and TR responses at the second review meeting predicted follow-up FCR. The study shows the effect of communication processes on this specific distress component of the patient's survivorship experience.

Revision of the fear of cancer recurrence cognitive and emotional model by Lee‐Jones et al with women with breast cancer

“…There is current movement to conduct empirical investigations of FCR, determine its theoretical components and better understand the consequences of FCR to one's health. When these data become available, they will provide further insight into how to conceptualize, measure, and intervene in the management of FCR . At this time, the existing theories relevant to understanding FCR, such as the revised model by Lee‐Jones et al presented in this study, provide novel conceptualizations of the construct of FCR.…”

“…When these data become available, they will provide further insight into how to conceptualize, measure, and intervene in the management of FCR. 55…”

A qualitative exploration of the fear of recurrence among Taiwanese breast cancer survivors

“…In the current study, seeking reassurance from healthcare professionals or threat monitoring behaviours and requesting unplanned medical examinations reflected insecurity. Providers must use validated screening measures, such as the Fear of Cancer Recurrence Inventory‐Short Form (FCRI‐SF) (Fardell et al, ), to assess FCR during follow‐up and provide adequate support, such as talking about emotions (Humphris, Yang, Barracliffe, Cameron, & Bedi, ), or to refer patients to further support services.…”

Physicians privilege responding to emotional cues in oncologic consultations: A study utilizing Verona Coding Definitions of Emotional Sequences

“…In the oncologic context, a study (Humphris et al, 2019) investigated the emotional communication of breast cancer patients in review consultations during radiotherapy and explored the fear of the occurrence of relapses in up to 8 weeks of follow-up. Patients expressed many concerns about relapse, presenting physical symptoms, fear, and uncertainty about the efficacy of the treatment, and characterizing underlying emotional cues.…”

“…The study provided evidence that even the patients who clearly express their concerns are not always understood and cared for by their physician. As a result, physicians, unrecognizing these concerns, may reinforce that the patient does not express psychological symptoms at the consultation (Humphris et al, 2019). Expressions such as fear, anger, and sadness are verbalized by cancer patients in medical consultations.…”