Satisfaction of Breast Cancer Patients with Their Medical and Psychological Care

Abstract

This study examined breast cancer patients' satisfaction with their medical and psychological care at the time of surgery and one year later. Data were collected during a larger randomized, controlled trial of preoperative psychological preparation for mastectomy. Interviews were conducted with 162 patients the day before surgery, and 237 follow-up interviews were conducted one year later. A taxonomy of patients' positive and negative reactions was constructed naturalistically from their statements during the interviews about the quality of their medical and psychological care, and the sum of these reactions was calculated for each interview period. The patients' coping skills were assessed using the classifications in The Mental Attitudes to Cancer Scale: Denial, Fighting Spirit, Stoic Acceptance, Helplessness/Hopelessness, and Anxious Preoccupation During each interview, the patients also completed the Hospital Anxiety and Depression Scale (HADS). Overall distress scores were compiled from HADS data collected during the follow-up interviews. Patients reacted more positively than negatively to the service they received. Before surgery, complaints were positively correlated with the fighting spirit or anxious preoccupation style of coping and with anxiety and depression and were negatively correlated with denial and stoic acceptance and with age. Patients in lower socioeconomic groups complained less than did those in higher socioeconomic groups. A year later, complaints were positively correlated with overall distress scores. Patients with cancer plus other illnesses or with recurrent cancer complained the most. The complaints that were recorded-107 preoperatively and 195 at one year-point to aspects of service that need to be improved, especially regarding physician-patient communication.