Trust in Physician in Relation to Blame, Regret, and Depressive Symptoms Among Women with a Breast Cancer Experience

Abstract

Following a diagnosis of breast cancer women experience considerable distress and often present with elevated symptoms of depression. A woman's relationship with her oncologist, and particularly trust in the physician, might influence depressive symptoms, as well as emotional and cognitive reactions to medical decisions made concerning treatment. To assess these relationships, women currently undergoing treatment for breast cancer (n = 40) and women who had previously been treated for breast cancer (n = 74) were asked about (1) trust in their physician, (2) who they blamed for negative events during treatment, (3) who made the treatment decisions, (4) regret, and (5) depressive symptoms. As well, community participants (n = 146) without breast cancer were asked about trust in their physician, levels of depression, and questions regarding blame if they hypothetically had breast cancer. Depression was greatest among women in treatment, and trust in physician was greatest among women posttreatment. However, trust in physician was neither related to depressive symptoms, decision making, nor responsibility for presence of metastases/relapse. Paradoxically, greater trust in physician was related to increased blame of the doctor for other negative events that had occurred. Furthermore, depressive scores were higher among women who blamed their doctor for negative events in comparison to women who ascribed blame to no one. As well, individuals who blamed themselves for negative events reported greater regret than individuals who blamed no one. Thus, though a woman may not hold her physician directly responsible for health outcomes, this relationship may be important to consider in other aspects of her psychological well-being.

KEYWORDS:

• breast cancer
• trust in physician
• blame
• regret
• depressive symptoms

Acknowledgments

This research was supported by Grant MOP – 81118 from the Canadian Institutes of Health Research and by a fellowship (KDR-96177) to SAT from the Canadian Institutes of Health Research.