Impact of Physician Behavior on Cancer Distress

Primary outcomes

1. Explore what physician behaviors contribute to patients' cancer distress

   Time frame: Baseline (at enrollment)

   Participants will indicate levels of distress on an 11-point Likert scale (10=extreme distress; 0=no distress). Physician behaviors that contribute to patients' cancer distress (as reported by patients) will be assessed using a free-text question. Topics and contextual factors will be identified by searching for themes with a thematic analysis. Descriptive statistics will be utilized to broadly analyze results. Data will initially be analyzed in its entirety. Subgroup analyses will then be done for patients who have vs have not experienced clinically significant distress (past or current score of 4+ on the distress thermometer). Additional subgroup analyses may be conducted depending on response.

2. Explore what physician behaviors lessen patients' cancer distress

   Time frame: Baseline (at enrollment)

   Participants will indicate levels of distress on an 11-point Likert scale (10=extreme distress; 0=no distress). Physician behaviors that lessen patients' cancer distress (as reported by patients) will be assessed using a free-text question. Topics and contextual factors will be identified by searching for themes with a thematic analysis. Descriptive statistics will be utilized to broadly analyze results. Data will initially be analyzed in its entirety. Subgroup analyses will then be done for patients who have vs have not experienced clinically significant distress (past or current score of 4+ on the distress thermometer). Additional subgroup analyses may be conducted depending on response.

3. Explore how non-physician factors in the patient care experience contribute to patients' cancer distress

   Time frame: Baseline (at enrollment)

   Participants will indicate levels of distress on an 11-point Likert scale (10=extreme distress; 0=no distress). Other factors that contribute to patients' cancer distress (as reported by patients) will be assessed using a free-text question. Topics and contextual factors will be identified by searching for themes with a thematic analysis. Descriptive statistics will be utilized to broadly analyze results. Data will initially be analyzed in its entirety. Subgroup analyses will then be done for patients who have vs have not experienced clinically significant distress (past or current score of 4+ on the distress thermometer). Additional subgroup analyses may be conducted depending on response.

4. Explore how non-physician factors in the patient care experience lessen patients' cancer distress

   Time frame: Baseline (at enrollment)

   Participants will indicate levels of distress on an 11-point Likert scale (10=extreme distress; 0=no distress). Other factors that lessen patients' cancer distress (as reported by patients) will be assessed using a free-text question. Topics and contextual factors will be identified by searching for themes with a thematic analysis. Descriptive statistics will be utilized to broadly analyze results. Data will initially be analyzed in its entirety. Subgroup analyses will then be done for patients who have vs have not experienced clinically significant distress (past or current score of 4+ on the distress thermometer). Additional subgroup analyses may be conducted depending on response.

5. Patient ratings of preference for physician-initiated conversations

   Time frame: Baseline (at enrollment)

   Patient ratings of preference for physician-initiated conversations on five sensitive topics: mental health, sexual health, financial health, cancer survival and mortality/prognosis, and personal relationship dynamics will be assessed using a study-specific survey. Responses are recorded on a Likert scale of 0-10 where 0=not at all and 10=very much so. Descriptive statistics will be utilized to analyze results.

6. Patient ratings of contributors to distress

   Time frame: Baseline (at enrollment)

   Patient ratings of how much sexual health, finances, cancer survival and prognosis, and changes in personal relationship dynamics contribute to their distress will be assessed using a study-specific survey. Each item will be rated on a Likert scale of 0-10 where 0=not at all and 10=very much so. Descriptive statistics will be utilized to analyze results.