Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

The physician-patient relationship and the experience of pain: A study of women undergoing diagnostic mammography  (#429)

Ingeborg Farver 1 , Christina Gundgaard Pedersen 1 , Berit Lassesen 2 , Anders Bonde Jensen 3 , Søren Christensen 1 , Robert Zachariae 1 3
  1. Unit for Psychooncology and Health Psychology, Aarhus University, Aarhus, Denmark
  2. Aarhus University, Centre for Teaching and Learning, Aarhus, Denmark
  3. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

Background: Although non-invasive, women often report pain during mammography. However, the variability of pain reports is high, making it relevant to explore potential factors influencing the experience of mammography pain. Several studies have investigated biological and psychological predictors, but fewer have explored the influence of situational circumstances on mammography-related pain.

Aim: To explore the possible influence of the physician-patient relationship on perceived mammography pain.

Method: As part of a larger study, 804 women referred by their GP to a mammography at the Department of Radiology, Aarhus University Hospital, Denmark, completed questionnaires approximately seven days before the mammography including measures of sociodemographic factors and immediately after the mammography including a visual-analogue pain rating scale (VAS), the Physician-Patient Relationship Inventory (PPRI), and two single items concerning their general satisfaction with the personal contact with the physician (satPER) and the physician’s ability to handle the medical aspects of the consultation (satMED).

Results: The 549 women (mean age: 47.9) who had rated their pain experience (pain: 230, no pain: 319) were included in the analysis. When entering PPRI total score or satPER and satMED, together with age, BMI, educational level, and cancer risk group as independent variables in two multiple logistic regressions with pain vs. no pain as the dependent outcome, only PPRI (OR=0.97; p=0.001; CI:0.96-0.99) and satPER(OR=0.75; p=0.024; CI:0.59-0.96) reached statistical significance.

Conclusion: In the present study, a more positive perception of the physician-patient relationship, especially of the personal contact with the physician, was significantly associated with less perceived mammography-related pain.

Implications: The present findings suggest that physicians performing mammography should be aware of the possible influence of their communication on the women’s pain experience. Future studies examining possible mediating factors, e.g. anxiety and coping strategies, are needed, as are prospective studies examining directions of causality.