Association between oncologists’ dispositional affect and depressive symptoms in their patients with metastatic cancer.

Abstract

214 Background: While caring for patients with metastatic cancer can be emotional, relationships between the emotions of oncologists and their patients have not been examined. As patients and oncologists read emotional cues in encounters, emotions of one or both may impact the other. We explored associations between dispositional affect, tendencies to emotionally respond to situations in certain ways, in oncologists and depressive symptoms in their patients with newly diagnosed metastatic lung and gastrointestinal (GI) cancers. Methods: As part of an ongoing trial of early palliative care, participants were assessed at baseline for depressive symptoms (Patient Health Questionnaire-9, PHQ9) within 8 weeks of diagnosis with metastatic lung and GI cancers. Oncologists providing care for these patients completed the Positive and Negative Affect Scale (PANAS), a validated measure of dispositional affect with positive and negative dimensions. Associations between patient depressive symptoms and oncologists' positive and negative dispositional affect were tested with linear regression models. Results: Sixteen of the 18 oncologists with patients in the trial completed the PANAS. Among 323 participants with baseline assessments, 277 (86%) had oncologists who completed the PANAS. Mean age=64.6, 129 (46%) were female, 159 (57%) had GI and 118 (43%) lung cancer, and mean PHQ9 score=6.5. Positive and negative dispositional affect were not associated with oncologists’ sex, years from training, hours in clinic, and cancer specialization. Patient depressive symptoms were significantly higher if their oncologists reported greater negative dispositional affect (p=.04). The relationship remained significant adjusting for patient age, sex, cancer type, ECOG PS, smoking, and number of oncology visits (β=.13, t=2.1, p=.04). PHQ9 scores were not associated with oncologists’ positive dispositional affect. Conclusions: Depressive symptoms in patients with metastatic lung and GI cancers appear to be associated with their oncologists’ negative dispositional affect. Determining the direction of the association may lead to new ways of improving patients and/or oncologists moods.