ABSTRACT
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.
Subject(s)
Adaptation, Psychological , Breast Neoplasms/psychology , Depression/psychology , Mindfulness , Referral and Consultation , Stress, Psychological/psychology , Adult , Aged , Anxiety/psychology , Attitude to Health , Female , Humans , Interviews as Topic , Middle Aged , Physician-Patient Relations , Qualitative Research , Surveys and QuestionnairesABSTRACT
OBJECTIVES: To explore why people who have active work and who experience suboptimal health avoided using a multipurpose in-house health promotion service in the Danish police. METHODS: Data were first collected via an electronic survey (N=6060) and subsequently via 25 telephone interviews targeting nonusers who perceived their health to be suboptimal. RESULTS: Many nonusers with suboptimal health wished to change health behaviors, but did not use the service. Reasons were both individual (eg, laziness) and organizational (eg, delivery of the service). CONCLUSIONS: Although many reported barriers are more individual in nature, increased information and accessibility could serve to increase participation.
