Communicating about concerns in oncology

Cancer is a life-threatening disease that evokes many concerns in patients. When these concerns accumulate they can lead to psychological distress. This can influence patients’ suffering and overall well-being. Optimal communication between patients and providers is a good way to prevent this accumulation. A crucial element for achieving optimal communication is that the patient clearly expresses his/hers concerns during a consultation. However, this does not always happen. In part because some patients do not clearly express their concerns but rather express them as indirect cues or hints. These cues and hints are more difficult for a provider to detect and to respond to than clear expressed concerns. Patients may benefit from communication interventions that aim to improve their concern expression. The effects of existing interventions are small and inconclusive. More research is therefore needed to investigate how concern expression can be improved. To determine how concern expression can be improved, it is important to understand which factors explain and support cancer patients’ concern expression. The aim of this dissertation is to investigate these factors. The factors that explain and support concern expression were examined from two theoretical perspectives; the behavior change and the stress coping perspective.