Breast cancer and communication: monocentric experience of a self-assessment questionnaire.

Abstract

Background: The communication of the diagnosis of breast cancer induces to the patient a strong psychological trauma. Radiologists are at the forefront of communicating, either for a biopsy or the probable diagnosis of malignancy. This is a complex task, which requires the knowledge and application of correct “communicative models”, among which the SPIKES protocol represents a fundamental reference.Design and methods: 110 patients, with a history of breast cancer, filled out a questionnaire consisting of six questions: five aimed at defining communication compliance with the SPIKES protocol, the sixth, consisting of six feelings, aimed at the knowledge of the next emotional state.Results: Regarding compliance with various “strategic points” of the SPIKES protocol, questionnaires show that 70% of patients reported no omissions, while the remaining 30% reported omissions relatively to perception (56%), emotions (23%), setting (13%), knowledge (6%) and invitation (2%). The results showed the existence of a correlation between the final emotional state and the correct application of the SPIKES protocol; in fact, patients who reacted with a positive final emotional state-reported greater adherence to the strategic points of the SPIKES protocol.Conclusions: In healthcare, knowing the communicative compliance of a team in giving “bad news” is fundamental, especially in breast cancer. The SPIKES protocol is recognized by the Literature as a fundamental reference able to affect “positively” the emotional state of patients. The proposed questionnaire is a valid tool to identify the weak points of communication and related criticalities, to improve clinical practice. Significance for public health The attention of the scientific community is often focused on analyzing the pathologies that afflict the human being, and more frequently there is a tendency to overshadow what is the interpersonal relationship with the patient, which is what underlies the trust relationship that must necessarily be established between doctors and patients to facilitate a correct diagnostic and therapeutic process. In this study, we tried to understand what the weaknesses of our approach may be to breast cancer diagnosis communication, to improve our communication skills and offer a better service. We propose an easily reproducible protocol aimed at highlighting the criticalities of an extremely delicate process that every Breast Team must face daily.