The influence of pre-visit anxiety on patient-provider communication and breast cancer patient uncertainty

Abstract Purpose: Effective communication between cancer patients and providers is critical for addressing psychological distress, reducing uncertainty, and promoting patient well-being. This is particularly relevant during medical appointments that may elicit uncertainty, such as surgical consultations for newly diagnosed women with breast cancer. This study aimed to evaluate how pre-appointment anxiety affects patient-provider communication in breast cancer surgical consultations and subsequent post-appointment well-being. Breast cancer patient anxiety has been studied as an outcome of provider communication, though less is known about the extent to which pre-existing anxiety acts as an antecedent to effective patient-provider communication. Methods: This study analyzed videorecorded breast cancer surgical consultations (N = 51) and corresponding patient surveys to understand how pre-appointment anxiety influences pre-appointment patient uncertainty, patient-provider communication during the appointment, and subsequent post-appointment uncertainty. Results: Overall, patients with elevated pre-appointment anxiety (n = 12) did not have more pre-appointment uncertainty but were interrupted by their provider at a higher rate than those without anxiety. The proposed model achieved good fit to the data such that more pre-appointment anxiety was associated with more pre-appointment uncertainty, more pre-appointment anxiety was associated with more empathic opportunities per minute, and more empathic opportunities were associated with less post-appointment uncertainty. Conclusions: Results provide new understanding for how patient anxiety acts as an antecedent to effective patient-provider communication and how this affects patient uncertainty post-appointment. Assessing breast cancer patients’ psychological well-being is crucial for identifying those at higher risk of poor health outcomes and providing holistic cancer care.