Provider perspectives on presenting risk information and managing worry about recurrence among breast cancer survivors

• Published in: Psycho-oncology (Chichester, England) England), 2015-05, Vol.24 (5), p.592-600
• Main Authors: Janz, Nancy K., Leinberger, Rebecca L., Zikmund-Fisher, Brian J., Hawley, Sarah T., Griffith, Kent, Jagsi, Reshma
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anxiety - psychology; Anxiety - therapy; Attitude of Health Personnel; Breast Cancer; Breast Neoplasms - psychology; Cancer; Communication; Disclosure; Disease Management; Female; Humans; Male; Medical Oncology; Middle Aged; Neoplasm Recurrence, Local - psychology; Oncology; Physician-Patient Relations; Quality of care; Risk; Surgeons; Survivor; Survivors - psychology; Survivorship; Worry; Worry about recurrence
• ISSN: 1057-9249; 1099-1611
• DOI: 10.1002/pon.3625

Background Although worry about recurrence is a persistent concern among breast cancer survivors, little is known about physicians' confidence about presenting recurrence risk information, identifying women with considerable worry, and helping women manage worry. Methods Between January and June 2012, we surveyed 750 surgeons and 750 medical oncologists randomly sampled from the American Medical Association Physician Masterfile. We tested differences between surgeons and medical oncologists on confidence of presenting risk, identifying and managing worry using chi‐square statistic and Student's t‐tests and developed multiple variable logistic regression models to explain odds regarding confidence and use of different strategies for managing worry. Results The analytic sample included 403 surgeons and 363 medical oncologists (n = 766; response rate = 60%). Compared with surgeons, medical oncologists were significantly more likely to report confidence in: presenting risk information (87.5% vs 73.2%), identifying women who are worried (74.1% vs 63.9%), and managing worry (66.9% vs 52.4%). Confidence in managing worry was associated with more regular inquiry about worry (p = 0.009). Models of the likelihood of using different management strategies varied by provider type (e.g., surgeons more likely than medical oncologists to recommend support group or online resources, oncologists more likely to refer to psychologist or use medications, all p