Race and Patient Perception of InterpersonalProcesses of Care: Do They Influence Breast Cancer Stage at Diagnosis?

Black women have the greatest mortality from breastcancer despite greater incidence of the disease amongWhite women. Additionally, they are more likely to bediagnosed at late stages, although early detectionthrough screening is widely available. Patientsdemographics, socioeconomic and health insurancestatus, or psychosocial characteristics do not fullyexplain the discrepancies. This led to the hypothesisthat the interpersonal processes of care-social andpsychological aspects of physician/patientinteractions involving communication, decisionmaking, and interpersonal skills-also contributed tothe differences. Because primary care providers playa major role in cancer prevention and screening, thepresent study explored patients perception ofinterpersonal processes of care with regard to theirprimary care providers. Semi-structured interviewswere conducted with 80 Black and White womendiagnosed with breast cancer, using an instrumentdeveloped by Stewart and colleagues. Descriptive,bivariate and multivariate probit analyses wereconducted as well as a confirmatory factor analysis.This book will be most useful for health policystudents, researchers, and clinicians.

Claudia A. Rosu obtained her medical degree from the Universityof Medicine and Pharmacy Grigore T. Popa and her doctorate inhealth policy from the University of Maryland Baltimore County.