1 Institut for Psykologi, Department of Psychology, Faculty of Social Sciences, Københavns Universitet2 Department of Psychology, Study Council, Department of Psychology, Faculty of Social Sciences, Københavns Universitet3 Department of Psychology, Faculty of Social Sciences, Københavns Universitet4 Center for Humanistic Health Research, Department of Psychology, University of Copenhagen.5 Herlev Hospital6 Ringsted Hospital7 Danish Cancer Society8 Department of Psychology, Study Council, Department of Psychology, Faculty of Social Sciences, Københavns Universitet9 Department of Psychology, Faculty of Social Sciences, Københavns Universitet10 Danish Cancer Society
Breast cancer patients' own focus on talking about acceptance-based psychological coping predicts decreased psychological distress and depression
OBJECTIVE: To analyze whether qualitative themes in breast cancer patients' self-presentations predicted symptoms of psychological distress and depression in order to improve the consultation process. METHODS: Ninety-seven breast cancer patients gave unstructured, 10-min self-presentations at their first consultation in a clinical registered trial (CRT identifier: NCT00990977). Self-presentations were categorized thematically and the most prevalent themes investigated as predictors for scores on the symptom check-list 90-revised (SCL-90-R) and the center for epidemiological studies depression scale (CES-D). RESULTS: Among the qualitative themes, only the percentage of words spent on talking about 'Acceptance-based psychological coping' was related to symptoms. In regression models controlling for age, education and time since diagnosis, a stronger focus on acceptance-based coping predicted less psychological distress and depression, respectively. A cross-validation including only the first few minutes of speech per patient confirmed these results and supported their practical utility in health consultations. CONCLUSION: Patients' focus on acceptance-based coping significantly predicted decreased psychological distress and depression, respectively. No other qualitative themes predicted symptoms. Doctor-patient studies may benefit from combined qualitative-quantitative methods. PRACTICE IMPLICATIONS: While quantitative symptom assessment is important for a consultation, health care providers may improve their understanding of patients by attending to patients' presentations of acceptance-based psychological coping.
Patient Education and Counseling, 2014, Vol 97, Issue 2, p. 165-172