Examining Breast Cancer Patients’ Use of Emotional Expressions in Clinic Discussions of Sexual Health: A Mixed‐Methods Study
Fernanda Bittencourt Romeiro, Kristen Sorice, Jennifer Barsky ReeseABSTRACT
Objective
Sexual concerns are reported by many women with breast cancer (BC) and are often highly emotionally distressing. However, little is known about how BC patients express negative emotions during sexual health discussions. We examined emotional expressions used by BC patients during clinical discussions of sexual health, including whether expressions were explicit versus implicit, and identified whether use of such expressions was associated with demographic/clinical factors, sexual health topics and length of discussion, level of sexual concerns, or psychological distress.
Methods
Using a mixed‐methods design, we analyzed audio recorded clinic dialogue about sexual health from 75 BC outpatients participating in a patient‐focused sexual health communication intervention for emotional expressions. Pearson’s chi‐square, t‐tests, and Spearman’s correlation were used to analyze associations between emotional expressions and the study variables.
Results
Nearly two‐thirds of discussions (63%) contained emotional expressions (88% implicit; 74% raised by patient vs. clinician). Use of implicit expressions was associated with longer time since diagnosis ( p = 0.03) but not with patient age. Loss of sexual interest/excitement and general sexual issues arose more commonly in discussions where emotional expressions were present versus when not present ( p ’s ≤ 0.02). Compared to discussions with no emotional expressions, those with emotional expressions were 3 minutes longer ( p < 0.01) and patients expressing emotions reported more severe sexual concerns ( p = 0.003). The use of explicit expressions was associated with more severe depressive symptoms ( p = 0.03), but not anxiety symptoms.
Conclusion
Emotional expressions are common in sexual health discussions, highlighting the potentially distressing nature of these discussions for BC patients.