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

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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.

Trial registration

NCT02599506

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Acknowledgements

All patients and staff that participated are gratefully acknowledged.

Funding

The FORECAST study was supported generously by Breast Cancer Now (Reg. No. SP529).

Author information

Authors and Affiliations

  1. Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK

    G. Humphris, J. Cameron & C. Bedi

  2. Division of Population and Behavioural Science, Medical School, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK

    G. Humphris & L. Barracliffe

  3. Department of Psychiatry and Psychology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Y. Yang

Authors
  1. G. Humphris
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  2. Y. Yang
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  3. L. Barracliffe
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  4. J. Cameron
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  5. C. Bedi
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Corresponding author

Correspondence to G. Humphris.

Ethics declarations

The study was approved by East of Scotland Research Ethics Service (NRES reference number: 13/ES/0015) and registered with ClinicalTrials.gov, ID number: NCT02599506.

Conflict of interest

The authors declare that they have no conflict of interest.

Appendices

Appendix 1

Fig. 1
figure 1

Flow chart for the detailed sampling

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Appendix 2

Table 3 Examples of patient utterances and provider responses (using VR-CoDES system)
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Appendix 3

Table 4 Pearson correlation matrix
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Humphris, G., Yang, Y., Barracliffe, L. et al. Emotional talk of patients with breast cancer during review appointments with therapeutic radiographers: effects on fears of cancer recurrence. Support Care Cancer 27, 2143–2151 (2019). https://doi.org/10.1007/s00520-018-4484-7

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  • DOI: https://doi.org/10.1007/s00520-018-4484-7

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