Does emotional talk vary with fears of cancer recurrence trajectory? A content analysis of interactions between women with breast cancer and their therapeutic radiographers

Funding: Breast Cancer Now (grant number 6873).Fears of cancer recurrence (FCR) in patients with breast cancer are hypothesised to develop over the period from diagnosis, through treatment and thereafter. A crucial point may be the contact that patients have with their therapeutic radiographer in review appointments. The study aimed to (1) describe and categorise the content of the identified emotional talk, and (2) consider the evidence for an association of content with FCR trajectory. Methods: A concurrent mixed methods approach was applied as part of a larger investigation (FORECAST) of breast cancer patients (n = 87). Patients completed a daily diary during their radiotherapy treatment. Audio recordings were collected of review appointments. The Verona Coding Definitions of Emotional Sequences (VR-CoDES) system was used to code patient emotional cues and concerns (CCs). Purposeful sampling of the daily diary ratings identified 12 patients (30 consultations) with an increasing (n=6) or decreasing (n=6) FCR trajectory. The emotional talk of these patients at their weekly reviews was content analysed. Results: Four themes were identified from 185 CCs: Physical Symptoms, Factors External to Hospital, Treatment, and Labelling Cancer. FCR decreasing trajectory group consultations were longer (p < 0.02), expressed twice as many CCs as the increasing trajectory group (p < 0.001), and were more likely to refer to cancer directly (p < 0.05). Conclusions: The emotional content expressed matched features outlined in the Lee-Jones et al (1997) FCR model, and showed evidence of avoidance in increasing FCR trajectory patients.PostprintPeer reviewe

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

FORECAST study supported generously by Breast Cancer Now (Reg. No. SP529).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 NCT02599506PostprintPeer reviewe