Document Detail


Breast reconstructive surgery in medically underserved women with breast cancer: the role of patient-physician communication.
MedLine Citation:
PMID:  19626696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Breast reconstructive surgery can improve mastectomy patients' emotional relationships and social functioning, but it may be underutilized in low-income, medically underserved women. This study assessed the impact of patient-physician communication on rates of breast reconstructive surgery in low-income breast cancer (BC) women receiving mastectomy.
METHODS: A cross-sectional, California statewide survey was conducted of women with income less than 200% of the Federal Poverty Level and receiving BC treatment through the Medicaid Breast and Cervical Cancer Treatment Program. A subset of 327 women with nonmetastatic disease who underwent mastectomy was identified. Logistic regression was used for data analysis. The chief dependent variable was receipt of or planned breast reconstructive surgery by patient report at 6 months after diagnosis; chief independent variables were physician interactive information giving and patient perceived self-efficacy in interacting with physicians.
RESULTS: Greater physician information giving about BC and its treatment and greater patient perceived self-efficacy positively predicted breast reconstructive surgery (OR=1.12, P=.04; OR=1.03, P=.01, respectively). The observed negative effects of language barriers and less acculturation among Latinas and lower education at the bivariate level were mitigated in multivariate modeling with the addition of the patient-physician communication and self-efficacy variables.
CONCLUSIONS: Empowering aspects of patient-physician communication and self-efficacy may overcome the negative effects of language barriers and less acculturation for Latinas, as well as of lower education generally, on receipt of or planned breast reconstructive surgery among low-income women with BC. Intervening with these aspects of communication could result in breast reconstructive surgery rates more consistent with the general population and in improved quality of life among this disadvantaged group.
Authors:
Rose C Maly; Yihang Liu; Elaine Kwong; Amardeep Thind; Allison L Diamant
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cancer     Volume:  115     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-13     Completed Date:  2009-12-01     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4819-27     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2009 American Cancer Society.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Attitude to Health
Breast Neoplasms / ethnology,  psychology*,  surgery*
Communication
Educational Status
Female
Hispanic Americans / statistics & numerical data
Humans
Mammaplasty / psychology*,  statistics & numerical data*
Middle Aged
Physician-Patient Relations*
Poverty
Self Efficacy
Grant Support
ID/Acronym/Agency:
1R01CA119197-01A1/CA/NCI NIH HHS; R01 CA119197/CA/NCI NIH HHS; R01 CA119197-01A1/CA/NCI NIH HHS
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