JMIR Publications

ABSTRACT

Background:

Prior studies indicate that the age of onset of breast cancer is an important element in considering communication between patients and the healthcare team. Younger women ages 45 and under diagnosed with breast cancer are often at a higher risk of being more vulnerable to psychosocial issues as compared to older women. While doctor-patient communication is the primary way women with breast cancer learn about important elements of their cancer therapy and post-treatment survivorship, few studies have examined age differences in patient perceptions of treatment-related discussions and of communications during transition with their healthcare team.

Objective:

The aims of this survey were: 1) to better understand breast cancer survivors’ perspectives of healthcare providers communication during treatment and in transition to post-treatment, and 2) to determine the differences between younger women with breast cancer (<45 years of age) as compared to older women (>46 years of age and older). It was hypothesized that 1) breast cancer survivors’ psychosocial and finance-related communications with healthcare providers may lack effectiveness; 2) younger women experience greater needs in physician and healthcare providers’ patient-centered communication, especially around psychosocial care and transition to post-treatment; and 3) younger breast cancer patients (<45 years of age) need more information on survivorship and follow-up care.

Methods:

An online survey was conducted with 143 women in Central Texas with 35.% (n=50) age 45 or under and 65% (n=93) ages 46 and above. The participants were invited via email links from a number of Texas-based cancer and breast cancer advocacy groups. The Mann–Whitney U test was performed to assess differences in participants’ perceptions about communication with healthcare providers by age group: young (<45 years of age) and old (≥ 46 years of age).

Results:

Participants were asked to score question areas such as concerns during treatment and how much discussion occurred between patients and providers. Statistically significant results were in regard to rating healthcare team and patient discussions about the transition from treatment to post-treatment using a score of 0 as “no discussion” and 100 as “in-depth discussion.” For the questions about management of post treatment care the group mean score was 56.26; the younger group mean was 43.96; the older group mean was 61.96 (P=.022). For the question about the timing of follow-up appointments, the overall group mean was 64.29; the younger group mean was 54.44; the older group mean was 68.88 (P=.049). For the overall group, scores related to psychosocial and financial support discussions with healthcare providers during the transition to post treatment care were low, with a rollup average of only 30.02 out of 100, suggesting that this is an important area for improving patient-centered communications.

Conclusions:

For all patients, transition from treatment to post-treatment require greater healthcare team engagement and communications. It appears that younger patients age <45 have needs for more in-depth and personalized messaging to better understand their post-treatment care requirements.