BMJ  2004;328:864 (10 April), doi:10.1136/bmj.38046.771308.7C (published 30 March 2004)

Paper

Doctors' communication of trust, care, and respect in breast cancer: qualitative study

¹ Royal Liverpool University Hospital, Liverpool L7 8XP, ² Linda McCartney Centre, Royal Liverpool University Hospital, ³ Department of Clinical Psychology, University of Liverpool, Liverpool L69 3GB

Objective To determine how patients with breast cancer want their doctors to communicate with them.

Design Qualitative study.

Setting Breast unit and patients' homes.

Participants 39 women with breast cancer.

Main outcome measure Patients' reports of doctors' characteristics or behaviour that they valued or deprecated.

Results Patients were not primarily concerned with doctors' communication skills. Instead they emphasised doctors' enduring characteristics. Specifically, they valued doctors whom they believed were technically expert, had formed individual relationships with them, and respected them. They therefore valued forms of communication that are currently not emphasised in training and research and did not intrinsically value others that are currently thought important, including provision of information and choice.

Conclusions Women with breast cancer seek to regard their doctors as attachment figures who will care for them. They seek communication that does not compromise this view and that enhances confidence that they are cared for. Testing and elaborating our analysis will help to focus communication research and teaching on what patients need rather than on what professionals think they need.

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