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The psychological responses of outpatient breast cancer patients before and during first medical consultation

Published online by Cambridge University Press:  30 September 2009

Shigemi Okazaki ,
Yumi Iwamitsu ,
Kuranami Masaru ,
Keiko Todoroki ,
Shimako Suzuki ,
Kenji Yamamoto ,
Masashi Hagino ,
Masahiko Watanabe  and
Hitoshi Miyaoka
Shigemi Okazaki*
Affiliation:
Department of Medical Psychology, Kitasato University, Graduate School of Medical Sciences, Kanagawa, Japan Higashiyamato General Hospital, Tokyo, Japan
Yumi Iwamitsu
Affiliation:
Department of Medical Psychology, Kitasato University, Graduate School of Medical Sciences, Kanagawa, Japan
Kuranami Masaru
Affiliation:
Department of Surgery, Kitasato University, School of Medicine, Kanagawa, Japan
Keiko Todoroki
Affiliation:
Department of Psychiatry, Kitasato University, School of Medicine, Kanagawa, Japan
Shimako Suzuki
Affiliation:
Department of Psychiatry, Kitasato University, School of Medicine, Kanagawa, Japan
Kenji Yamamoto
Affiliation:
Department of Psychiatry, Kitasato University, School of Medicine, Kanagawa, Japan
Masashi Hagino
Affiliation:
Department of Medical Psychology, Kitasato University, Graduate School of Medical Sciences, Kanagawa, Japan
Masahiko Watanabe
Affiliation:
Department of Surgery, Kitasato University, School of Medicine, Kanagawa, Japan
Hitoshi Miyaoka
Affiliation:
Department of Psychiatry, Kitasato University, School of Medicine, Kanagawa, Japan
*
Address correspondence and reprint requests to: Shigemi Okazaki, Higashiyamato General Hospital, 1-13-12 Nangai, Higashiyamato, Tokyo 207-0014, Japan. E-mail: [email protected]
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Abstract

Objective:

The purpose of this study was to qualitatively examine the content of the psychological responses in interviews with breast cancer outpatients receiving initial medical consultation.

Method:

The participants were 180 people who visited the breast cancer outpatient clinic at Kitasato University Hospital between November 2004 and August 2005. The remaining 176 participants (39 breast cancer patients and 137 benign tumor patients; average age ± SD: 50.7 ± 12.4 years) were analyzed. Two clinical psychologists carried out the interview, asking the participants to speak freely about their anxieties, worries, thoughts, and feelings up until the medical examination. This study used a content analysis of interviews to chronologically examine psychological response of cancer patients seeking medical consultation at three points in time.

Results:

Patients at the time of their first outpatient breast cancer consultation experience negative feelings before the examination, directly influenced by the suspicion of cancer. These include anxiety and worries, fear, evasion, depression, and impatience. These tendencies do not change at the time of consultation. However, in addition to negative feelings, some people also possess positive feelings, either simultaneously or at a different point in time. Further, many patients tend to talk at length about psychological responses before seeking treatment, understanding the process they went through to come to seek treatment as an important event.

Significance of results:

It is important for medical workers to bear in mind the psychological conflicts that patients may undergo before seeking treatment and ensure that sufficient communication takes place.

Keywords

CancerOncologyPsychological responsesMedical consultationQualitative study
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 3 , September 2009 , pp. 307 - 314
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

Bardwell, W.A., Natarajan, L., Dimsdale, J.E., et al. (2006). Objective cancer-related variables are not associated with depressive symptoms in women treated for early-stage breast cancer. Journal of Clinical Oncology, 24, 2420–2427.CrossRefGoogle Scholar
Boehmke, M.M. & Dickerson, S.S. (2005). Symptom, symptom experiences, and symptom distress encountered by women with breast cancer undergoing current treatment modalities. Cancer Nursing, 28, 382–389.CrossRefGoogle ScholarPubMed
Boehmke, M.M. & Dickerson, S.S. (2006). The diagnosis of breast cancer: Transition from health to illness. Oncology Nursing Forum, 33, 1121–1127.CrossRefGoogle ScholarPubMed
Bovbjerg, D.H., Montgomery, G.H. & Raptis, G. (2005). Evidence for classically conditioned fatigue responses in patients receiving chemotherapy treatment for breast cancer. Journal of Behavioral Medicine, 28, 231–237.CrossRefGoogle ScholarPubMed
Carver, C.S., PozoKaderman, C., Price, A.A., et al. (1998). Concern about aspects of body image and adjustment to early stage breast cancer. Psychosomatic Medicine, 60, 168–174.CrossRefGoogle ScholarPubMed
Cohen, M.Z., Kahn, D.L. & Steeves, R.H. (1998). Beyond body image: The experience of breast cancer. Oncology Nursing Forum, 25, 835–841.Google ScholarPubMed
Consedine, N.S., Magai, C., Krivoshekova, Y.S., et al. (2004). Fear, anxiety, worry, and breast cancer screening behavior: A critical review. Cancer Epidemiology Biomarkers Prevention, 13, 501–510.CrossRefGoogle ScholarPubMed
Hann, D., Winter, K. & Jacobsen, P. (1999). Measurement of depressive symptoms in cancer patients: Evaluation of the center for epidemiological studies depression scale (CES-D). Journal of Psychosomatic Research, 46, 437–443.CrossRefGoogle ScholarPubMed
Hirota, N., Kida, H., Aoki, T., et al. (1994). Study on the illness behavior of patients with breast cancer: Stress reaction to the illness and coping with illness. IRYO, 48, 917–923.Google Scholar
Holland, J.C. (1990 a). Clinical course of cancer. In Handbook of Psychooncology, Holland, J.C. & Rowland, J.H. (eds.), pp. 75–100. New York: Oxford University Press.Google Scholar
Holland, J.C. (1990 b). Fears and abnormal reactions to cancer in physically healthy individuals. In Handbook of Psychooncology, Holland, J.C. & Rowland, J.H. (eds.), pp. 13–21. New York: Oxford University Press.Google Scholar
Hosaka, T. & Aoki, T. (1996). Depression among cancer patients. Psychiatry and Clinical Neurosciences, 50, 309–312.CrossRefGoogle ScholarPubMed
Ito, T., Takei, A., Kanou, T., et al. (2004). Analysis of anxiety of cancer outpatients with high state-trait anxiety inventory (STAI) score. Ann Gunma Health Science, 25, 69–76.Google Scholar
Iwamitsu, Y., Shimoda, K., Abe, H., et al. (2005 a). Anxiety, emotional suppression and psychological distress before and after breast cancer diagnosis. Psychosomatics, 46, 19–24.CrossRefGoogle ScholarPubMed
Iwamitsu, Y., Shimoda, K., Abe, H., et al. (2005 b). The relation between negative emotional suppression and emotional distress in breast cancer diagnosis and treatment. Health Communication, 18, 201–215.CrossRefGoogle ScholarPubMed
Massie, M.J. & Holland, J.C. (1990). Overview of normal reactions and prevalence of psychiatric disorders. In Handbook of Psychooncology, Holland, J.C. & Rowland, J.H. (eds.), pp. 273–282. New York: Oxford University Press.Google Scholar
Mathews, A., Ridgeway, V., Warren, R. et al. (2002). Predicting worry following a diagnosis of breast cancer. Psycho-Oncology, 11, 415–418.CrossRefGoogle ScholarPubMed
Matsuki, M., Miki, F., Koshimura, T., et al. (1992). Longitudinal studies of psychological adjustment for mastectomy patients (1). Journal of Japanese Society of Nursing Research, 15, 20–28.Google Scholar
Mayring, P. (2004). Qualitative content analysis. In A Companion to Qualitative Research, Flick, U., Kardorff, E.V. & Steinke, I. (eds.), pp. 266–269. London: Sage.Google Scholar
Rosman, S. (2004). Cancer and stigma: Experience of patients with chemotherapy-induced alopecia. Patient Education and Counseling, 52, 333–339.CrossRefGoogle ScholarPubMed
Suzuki, K. & Komatsu, H. (2002). Cognitive appraisal of patients with cancer following telling about the diagnosis. Journal of Japanese Society of Cancer Nursing, 16, 17–27.Google Scholar
Tromp, D.M., Brouha, X.D.R., DeLeeuw, J.R.J., et al. (2004). Psychological factors and patient delay in patients with head and neck cancer. European Journal of Cancer, 40, 1509–1516.CrossRefGoogle ScholarPubMed
Uchitomi, Y., Akechi, T., Okamura, H., et al. (1998). Positive influence of a liaison program on the rate of psychiatric consultation referrals for cancer patients. Psychiatry and Clinical Neurosciences, 52, 275–278.CrossRefGoogle ScholarPubMed
Ueda, C., Seki, M. & Takemura, S. (2002). An analysis of breast cancer patients’ pre-operative and post-operative psychological states. Nursing College, Wakayama Medical University, 5, 9–25.Google Scholar