{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:40:10Z","timestamp":1792496410205,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","award":["MRSG\u201014\u2010031\u2010CPPB"],"award-info":[{"award-number":["MRSG\u201014\u2010031\u2010CPPB"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA006927"],"award-info":[{"award-number":["P30CA006927"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Sexual concerns are reported by many women with breast cancer (BC) and are often highly emotionally distressing. However, little is known about how BC patients express negative emotions during sexual health discussions. We examined emotional expressions used by BC patients during clinical discussions of sexual health, including whether expressions were explicit versus implicit, and identified whether use of such expressions was associated with demographic\/clinical factors, sexual health topics and length of discussion, level of sexual concerns, or psychological distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a mixed\u2010methods design, we analyzed audio recorded clinic dialogue about sexual health from 75 BC outpatients participating in a patient\u2010focused sexual health communication intervention for emotional expressions. Pearson\u2019s chi\u2010square, t\u2010tests, and Spearman\u2019s correlation were used to analyze associations between emotional expressions and the study variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nearly two\u2010thirds of discussions (63%) contained emotional expressions (88% implicit; 74% raised by patient vs. clinician). Use of implicit expressions was associated with longer time since diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03) but not with patient age. Loss of sexual interest\/excitement and general sexual issues arose more commonly in discussions where emotional expressions were present versus when not present (\n                      <jats:italic>p<\/jats:italic>\n                      \u2019s\u00a0\u2264\u00a00.02). Compared to discussions with no emotional expressions, those with emotional expressions were 3\u00a0minutes longer (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) and patients expressing emotions reported more severe sexual concerns (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.003). The use of explicit expressions was associated with more severe depressive symptoms (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03), but not anxiety symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Emotional expressions are common in sexual health discussions, highlighting the potentially distressing nature of these discussions for BC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70637","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T10:45:32Z","timestamp":1792493132000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining Breast Cancer Patients\u2019 Use of Emotional Expressions in Clinic Discussions of Sexual Health: A Mixed\u2010Methods Study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5195-4603","authenticated-orcid":false,"given":"Fernanda Bittencourt","family":"Romeiro","sequence":"first","affiliation":[{"name":"Cancer Prevention and Control Program Fox Chase Cancer Center  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5501-5782","authenticated-orcid":false,"given":"Kristen","family":"Sorice","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program Fox Chase Cancer Center  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9341-2407","authenticated-orcid":false,"given":"Jennifer Barsky","family":"Reese","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program Fox Chase Cancer Center  Philadelphia Pennsylvania USA"},{"name":"Department of Social and Behavioral Sciences College of Public Health Temple University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK\u201025\u2010472856"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2023.09.018"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11226723"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.864893"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2025.0028"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.102236"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70147"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5613"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/JSO.27602"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102023\u2010077067"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1005083"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2025.109386"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pecinn.2025.100374"},{"key":"e_1_2_11_15_1","volume-title":"McGraw Hill Medical [Internet]","author":"Ruben M. 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