Identification of pain, emotional distress, and suicidality among breast cancer patients: Gaps between patient reports and medical charts

Background: Healthcare providers frequently fail to identify mental health problems in cancer patients. In this preliminary study, we examined differences between patients’ self-report and documentation in medical charts in identification of pain, emotional distress and suicidality among women with breast cancer during the first months following diagnosis. Methods: A convenience sample of women with breast cancer (N=105) completed self-report questionnaires and their medical charts were reviewed by research assistants. Results: While a majority of patients reported suffering from some pain it was noted in less than fifth of the medical charts. Similarly, approximately a third of the patients self-reported mood and/or anxiety disorder, yet it was noted in only 2.8% of medical charts. Finally, six patients self-reported suicidal risk, but none of the medical charts included any report about patients’ suicidality. Conclusions: Providers should be educated about the importance and the rationale behind the need for assessment of emotional distress and trained to correctly identify it.