An Analysis of Health Care Team Communication Needs among Younger vs Older Breast Cancer Survivors: Web-Based Survey

Abstract

Background: Prior studies indicate that the age of onset of breast cancer is an important element in considering communication between patients and the health care team. Younger women aged 45 and under diagnosed with breast cancer are often at a higher risk of being more vulnerable to psychosocial issues compared to older women aged 46 years and above. Few studies have examined age differences in patient perceptions of treatment-related discussion and communication during transition with their health care team. Objective: The aims of this survey were (1) to better understand breast cancer survivors’ perspectives regarding communication with health care providers during treatment and during transition to posttreatment care; and (2) to determine the differences between younger women with breast cancer (≤45 years of age) and older women (≥46 years of age). It was hypothesized that (1) breast cancer survivors’ psychosocial and finance-related communications with health care providers may lack effectiveness; (2) younger women experience greater needs for patient-centered communication with physicians and health care providers, especially about psychosocial care and transition to posttreatment care; and (3) younger breast cancer patients (≤45 years of age) need more information on survivorship and follow-up care. Methods: An internet-based survey was conducted with 143 women in Central Texas with 35% (n=50) aged 45 years or under and 65% (n=93) aged 46 years and above. The Mann-Whitney U test was performed to assess differences in participants’ perceptions about communication with health care providers by age group: younger (≤45 years of age) and older (≥46 years of age) women. Results: Statistically significant results pertained to rating health care team and patient discussions about transition from treatment to posttreatment using scores of 0 as “no discussion” and 100 as “in-depth discussion.” For the questions about management of posttreatment care, the overall mean score of the groups was 56.26 and that of the younger group was 43.96; the mean score of the older group was 61.96 (P=.02). For the question about the timing of follow-up appointments, the overall mean score was 64.29; the mean score of the younger group was 54.44, and that of the older group was 68.88 (P=.05). All the group scores related to psychosocial and financial support discussions with health care providers were low, with a rollup average of only 30.02 out of 100, suggesting that this is an important area for improving patient-centered communication. Conclusions: For all patients, transition from treatment to posttreatment requires a greater level of engagement and communication with the health care team. It appears that younger patients aged ≤45 years require more in-depth and personalized messaging to better understand their posttreatment care requirements.