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

Emma Burkitt Wright, senior house officer in medicine1, Christopher Holcombe, consultant surgeon2, Peter Salmon, professor of clinical psychology3

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

Correspondence to: P Salmon psalmon{at}liv.ac.uk

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.


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

Relevant Articles

Communicating about screening
Vikki A Entwistle, Stacy M Carter, Lyndal Trevena, Kathy Flitcroft, Les Irwig, Kirsten McCaffery, and Glenn Salkeld
BMJ 2008 337: a1591. [Extract] [Full Text]

Doctors' communication of trust, care, and respect: Details of paper were incorrect
Lesley Fallowfield
BMJ 2004 328: 1317-1318. [Extract] [Full Text]

Doctors' communication of trust, care, and respect: Paper was muddled
Angela Coulter
BMJ 2004 328: 1318. [Extract] [Full Text]

Doctors' communication of trust, care, and respect: It takes two to make therapeutic relationship work
June Jones and Derek Willis
BMJ 2004 328: 1318. [Extract] [Full Text]

Doctors' communication of trust, care, and respect: Communication needs of all kinds of people should be explored
Joyce Carter
BMJ 2004 328: 1318. [Extract] [Full Text]

Patients want trustworthy and caring doctors
BMJ 2004 328: 0. [Full Text]

The teaching of communication skills may be misguided
Richard Smith
BMJ 2004 328: 0. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • VON WAGNER, C, KNIGHT, K, HALLIGAN, S, ATKIN, W, LILFORD, R, MORTON, D, WARDLE, J (2009). Patient experiences of colonoscopy, barium enema and CT colonography: a qualitative study. Br. J. Radiol. 82: 13-19 [Abstract] [Full text]  
  • Entwistle, V. A, Carter, S. M, Trevena, L., Flitcroft, K., Irwig, L., McCaffery, K., Salkeld, G. (2008). Communicating about screening. BMJ 337: a1591-a1591 [Full text]  
  • Berry, L. L., Parish, J. T., Janakiraman, R., Ogburn-Russell, L., Couchman, G. R., Rayburn, W. L., Grisel, J. (2008). Patients' Commitment to Their Primary Physician and Why It Matters. Ann Fam Med 6: 6-13 [Abstract] [Full text]  
  • Tong, A., Sainsbury, P., Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19: 349-357 [Abstract] [Full text]  
  • Wathen, C. N., Harris, R. M. (2007). "I Try to Take Care of It Myself." How Rural Women Search for Health Information. Qual Health Res 17: 639-651 [Abstract]  
  • Entwistle, V. A (2007). Differing perspectives on patient involvement in patient safety. Qual Saf Health Care 16: 82-83 [Full text]  
  • Aabom, B., Kragstrup, J., Vondeling, H., Bakketeig, L. S, Stovring, H. (2006). Does persistent involvement by the GP improve palliative care at home for end-stage cancer patients?. Palliat Med 20: 507-512 [Abstract]  
  • Bendapudi, N. M., Berry, L. L., Frey, K. A., Parish, J. T., Rayburn, W. L. (2006). Patients' Perspectives on Ideal Physician Behaviors. Mayo Clin Proc. 81: 338-344 [Abstract] [Full text]  
  • Steinsbekk, A., Launso, L. (2005). Empowering the Cancer Patient or Controlling the Tumor? A Qualitative Study of How Cancer Patients Experience Consultations With Complementary and Alternative Medicine Practitioners and Physicians, Respectively. Integr Cancer Ther 4: 195-200 [Abstract]  
  • Ammentorp, J., Mainz, J., Sabroe, S. (2005). Parents' Priorities and Satisfaction With Acute Pediatric Care. Arch Pediatr Adolesc Med 159: 127-131 [Abstract] [Full text]  
  • Coulter, A. (2004). Doctors' communication of trust, care, and respect: Paper was muddled. BMJ 328: 1318-1318 [Full text]  
  • Fallowfield, L. (2004). Doctors' communication of trust, care, and respect: Details of paper were incorrect. BMJ 328: 1317-1318 [Full text]  
  • Jones, J., Willis, D. (2004). Doctors' communication of trust, care, and respect: It takes two to make therapeutic relationship work. BMJ 328: 1318-1318 [Full text]  
  • Carter, J. (2004). Doctors' communication of trust, care, and respect: Communication needs of all kinds of people should be explored. BMJ 328: 1318-1318 [Full text]  

Rapid Responses:

Read all Rapid Responses

The time of diagnosis is important but so too is the time before and after
Christine M Habgood
bmj.com, 12 Apr 2004 [Full text]
Communication training for doctors
Debra Nestel
bmj.com, 15 Apr 2004 [Full text]
Communication - the needs of all kinds of people should be explored
Joyce M Carter
bmj.com, 15 Apr 2004 [Full text]
Thanks for the lecture about patient needs.
Lesley J Fallowfield
bmj.com, 16 Apr 2004 [Full text]
Re: Thanks for the lecture about patient needs.
Elizabeth Cockerell
bmj.com, 19 Apr 2004 [Full text]
It takes two to make a therapeutic relationship work
June Jones, et al.
bmj.com, 20 Apr 2004 [Full text]
Communication - information and choice are vital
Joanne Rule
bmj.com, 21 Apr 2004 [Full text]
Here we go again!
Rosetta Manaszewicz
bmj.com, 22 Apr 2004 [Full text]
Trust and respect require effective communication
Amanda J Ramirez, et al.
bmj.com, 23 Apr 2004 [Full text]
What a muddled paper!
Angela Coulter
bmj.com, 27 Apr 2004 [Full text]
what patients want in their doctors
heather j emmett
bmj.com, 27 Apr 2004 [Full text]
clinicians need a varied repetoire of communication skills
Susan M Wearne
bmj.com, 28 Apr 2004 [Full text]
sad misconception
Amanda C Howe
bmj.com, 10 May 2004 [Full text]
Overheated correspondence is unhelpful
Klim McPherson
bmj.com, 12 May 2004 [Full text]
Essentials of good communication to patients.
Sukumaran Srikumar, et al.
bmj.com, 17 May 2004 [Full text]
A comment of academic principles and qualitative research
Geraldine M Leydon, et al.
bmj.com, 20 May 2004 [Full text]
Just as valid without the patient interviews...?
Ben Riley
bmj.com, 20 Jun 2004 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ