Does physician communication style impact patient report of decision quality for breast cancer treatment?

Abstract

Objective: Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer.

Methods: Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive).

Results: Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality.

Conclusion: Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication.

Practice implications: Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality.

Keywords: Breast cancer; Decision making; Decision quality; Patient autonomy; Provider communication.