Cancer-related self-efﬁcacy following a consultation with an oncologist Berit Kjærside Nielsen 1,2 *, Mimi Mehlsen 1,2 , Anders Bonde Jensen 3 and Robert Zachariae 1,2 1 Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark 2 Department of Psychology, Aarhus University, Aarhus, Denmark 3 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark *Correspondence to: Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology, Aarhus University, Aarhus, Denmark. E-mail: beritkn@psy.au.dk Received: 25 May 2012 Revised: 21 January 2013 Accepted: 27 January 2013 Abstract Objective: When receiving a cancer diagnosis, patients are often faced with psychological distress and loss of control. As a result, their psychological well-being may be inﬂuenced by their perceived ability to cope with disease-related and treatment-related challenges. Research indicates that the patient–oncologist relationship may have an impact on patients’ self-efﬁcacy. The aim was to examine predictors of self-efﬁcacy following a consultation in an oncology outpatient clinic and the predictors of change. Methods: A total of 226 patients (mean age: 61 years, 40% male) attending an oncology outpatient clinic completed questionnaires before and after a consultation including the Hospital Anxiety and Depression Scale, two domain-speciﬁc self-efﬁcacy scales measuring coping self-efﬁcacy and decision self-efﬁcacy, the Physician–Patient Relationship Inventory, and the Information Satisfaction Questionnaire. Results: While most patients experienced an increase in self-efﬁcacy following the consultation, some patients experienced lower self-efﬁcacy post-consultation. In the multivariate analysis, depressive symptoms emerged as a relatively strong predictor of both coping self-efﬁcacy and decision self-efﬁcacy, whereas marital status was a signiﬁcant predictor of coping self-efﬁcacy, and satisfaction with information signiﬁcantly predicted decision self-efﬁcacy. No signiﬁcant associations were found between self-efﬁcacy and the patients’ ratings of the physician–patient relationship. Conclusion: Depression seems to be a potential risk factor for lower cancer-related self-efﬁcacy, following an oncologist consultation. By identifying patients who exhibit symptoms of depression, health professionals can increase their attention on empowering these patients. Furthermore, our results suggest that patients’ experience of self-efﬁcacy depends on what particular challenges they have to overcome. Copyright © 2013 John Wiley & Sons, Ltd. Introduction When receiving a cancer diagnosis, patients are often faced with psychological distress and loss of control [1,2]. They undergo exhausting treatment, are often challenged with complex information, and may be involved in difﬁcult decisions concerning their treatment and care. As a result, their psychological well-being may be inﬂuenced by their perceived ability to cope with disease-related and treatment-related challenges. Some patients go through feelings of helplessness and despair, whereas others uphold beliefs that they can exercise some control over their psychological well-being [3]. Self-efﬁcacy (SE) is an important concept in this context and is increasingly viewed as having a central role in the ways cancer patients cope [4–6]. In accordance to social cognitive theory, efﬁcacy beliefs play an important role in motivational regulation, and it states that a person’s behavior is cognitively mediated by the strength of one’s SE, with SE being deﬁned as the situation-speciﬁc belief a person has about one’s ability to maintain behavior that may lead to desired outcomes [7,8]. SE affect the amount of effort people put into a particular situation, the amount of stress experienced, and the degree to which they are susceptible to anxiety and depression [9,10]. A person’s SE beliefs are inﬂuenced by various sources of information, for example, mastery experience, vicarious experience, somatic and emotional state, and social persuasion. The latter refers to signiﬁcant others, who provide verbal support, which positively inﬂuences the level of SE. It serves as a booster of a person’s beliefs because it is easier to feel efﬁcacious if important others express their faith in one’s capabilities [8]. During the cancer course, patients perceive their oncologist as an important person, not only as the one responsible for their treatment but also a potential source of emotional and verbal encouragement [8]. Previous studies have found that patients with higher SE are less distressed, and show improved adjustment to disease and treatment [11–15]. Some results suggest that sociodemographic characteristics are associated with varying levels of SE, indicating that higher educated [13,16,17], older [13], and male cancer patients [6] tend to experience higher cancer-related SE. A growing body of research indicates that patient- centered approaches are associated with increased patient SE [18,19]. A patient-centered approach has been deﬁned as taking into account the patient’s preferences for information and shared decision making, listening and responding appropriately to the patient’s concerns, and meet- ing the patient’s informational and emotional needs [20–22]. Furthermore, physicians who engage in patient-centered communication are rewarded with positive patient outcomes, for example, improved recall of information, treatment compliance, and satisfaction with care [23,24]. Thus, the manner in which oncologists communicate with their cancer patients may thus have an impact on patients’ SE. Copyright © 2013 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology (2013) Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3261