It's Normal. Untrustworthy Memorable Messages in Formal Caregiving for Breast Cancer Patients.

Abstract

Background: The patient-doctor relationship, including communication, is recognised as a critical aspect of the patient experience. Memorable messages are a part of communication between patient and doctor. However, little is known which memorable messages reduce patients' trust in doctors or lead to distrust.

Aims: To reconstruct memorable messages which breast cancer patients recalled while receiving care from their clinicians leads patients to distrust doctors.

Methods: In-depth interviews were conducted with 24 breast cancer patients, in Poland and Croatia. Participants ranged in age from 34 to 76 years. Reflexive thematic analysis was used.

Results: Breast cancer patients recalled many memorable messages that reduce trust in oncology care. The overarching theme of untrustworthy memorable messages was developed, and it embraces three themes: seemingly caring memorable messages, careless memorable messages, missing expected memorable messages. They come in verbal, nonverbal and absent forms. Patient's responses to them include drawing attention directly to inappropriate communication, changing the doctor, learning to be better prepared for medical encounters, or passive adaptation.

Conclusions: These results enrich the studies on memorable messages, enhancing the understanding of communication behaviors in triggering distrust toward doctors. Although patients are aware that doctors are overworked, they expect care, attention, individual approach, understanding, and empathy. However, doctors sometimes give untrustworthy memorable messages - especially messages perceived as dismissive, harmful, inadequate, or absent although expected - throughout the cancer trajectory. Thus, greater attention should be given to eliminating untrustworthy memorable messages, improving the understanding of trust dynamics in oncology, psycho-oncology and health education.