Communication about Sexual Health in Breast Cancer: What Can We Learn from Patients' Self-Report and Clinic Dialogue?

Abstract

Research assessing clinical communication about sexual health is limited. We compared clinical communication about sexual health across patients' self-reports and coded dialogue in breast cancer outpatients. 134 patients had clinic visits audio-recorded and coded for sexual health communication and completed self-report questionnaires immediately after the visit. Associations between the self-report and dialogue were assessed using Phi coefficient. Agreements (present/absent) and discrepancies (omissions, commissions) about discussed topics were classified and discrepancies analyzed for themes. Sexual health was discussed in 61 of 134 patient visits (46%). Associations were significant (p < .01) but differed by topic (φ = .27-.76). 37 women (23%) had ≥ 1 self-report error. Discrepancies were common (19 omissions, 29 commissions). Patients often omitted communication about sexual concerns when such concerns were not problematic, and interpreted non-specific discussions as including specific topics of concern, even when not explicitly stated. Omissions were more common for women with lower education. Patients' reports of whether sexual health communication occurs does not always align with observed dialogue, and may vary by personal relevance of the topic. There are limitations in determining the prevalence of clinical communication about sexual health through patient self-report. Explaining sexual health terms might enhance shared understanding.