Determinants of breast cancer knowledge among newly diagnosed, low-income, medically underserved women with breast cancer.

Abstract

Among women with breast cancer (BC), greater BC knowledge has been associated with greater participation in treatment decision-making, patient satisfaction, and survival. The objective of this study was to identify modifiable determinants associated with BC knowledge. Data were collected from a telephone survey of medically underserved women with BC in California (n = 909). The dependent variable for analysis was BC knowledge. The modifiable determinants that were assessed included 1) physician-patient discussion of BC topics, 2) receipt of written BC-related material, 3) self-efficacy in interacting with physicians, 4) physician emotional support, 5) discussions with a BC survivor, and 6) office visit support by relatives/friends. Multivariate linear regression was used to examine the effect of those determinants on BC knowledge while controlling for socioeconomic factors, clinical characteristics, and treatment received. The average knowledge score was 6.9 (standard deviation, 2.3; range, 0-10). In multivariate analyses among women with less physician emotional support, those with the greatest self-efficacy had higher knowledge scores than those with the least self-efficacy (8.2 vs 5.4; P < .001). For women with low self-efficacy, those with more physician emotional support had higher knowledge scores than those with less physician emotional support when the analysis was controlled for confounding factors (6.3 vs 5.4; P < .001); physician information-giving had no effect on BC knowledge. The study findings suggested significant associations of patient self-efficacy and physician emotional support with BC knowledge; physician emotional support appeared to be more important than physician informational support. Further research will be needed to investigate whether interventions that target these 2 domains may be effective in increasing BC knowledge in disadvantaged populations.