Behind closed doors II: systematic analysis of prostate cancer patients' primary treatment consultations with radiation oncologists and predictors of satisfaction with communication
Behind closed doors II: systematic analysis of prostate cancer patients' primary treatment consultations with radiation oncologists and predictors of satisfaction with communication
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DOI：
10.1002/pon.1984
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发表时间：
2012-08-01
期刊：
影响因子：
3.6
通讯作者：
Degner, Lesley F.
中科院分区：
文献类型：
--
作者：
Hack, Thomas F.;Ruether, J. Dean;Degner, Lesley F.
目的本研究旨在阐明前列腺肿瘤主要治疗咨询的内容，并研究患者、重要他人和肿瘤科医生咨询因素与患者沟通满意度之间的预测关系。方法使用医学互动处理系统（MIPS）对来自加拿大三个癌症中心的156例新诊断前列腺癌患者的记录咨询进行检查。MIPS结果、独立观察者对患者、重要他人和肿瘤学家情感行为的评分，以及患者为中心、患者直接性和心理社会焦点的咨询比率，用于预测患者对咨询后和咨询后12周的沟通满意度。结果咨询内容以生物医学类为主，占86%，其次是行政类（9%）和心理社会类（5%）。咨询后的沟通满意度显着较低的患者，其显着的其他被评为更自信的咨询过程中，和那些被评为更焦虑的咨询过程中。在咨询过程中被评为更焦虑的患者，咨询后立即沟通满意度较低的患者和咨询时间较短的患者在咨询后12周对沟通的满意度明显较低。结论：前列腺肿瘤辅助治疗咨询的特点是医生提供的信息量高，生物医学讨论占主导地位，解决患者心理社会问题的时间相对较少。患者可能会受益于肿瘤学家谁解决焦虑和情绪困扰期间的主要治疗咨询，允许足够的时间，以确保患者离开咨询与他们的沟通需求得到满足。版权所有（c）2011约翰威利父子有限公司
Objective The purpose of this investigation was to explicate the content of primary treatment consultations in prostate oncology and examine the predictive relationships between patient, significant other, and oncologist consultation factors and patient satisfaction with communication. Methods The recorded consultations of 156 newly diagnosed prostate cancer patients from three Canadian cancer centers were examined using the Medical Interaction Process System (MIPS). The MIPS findings, independent observer ratings of patient, significant other, and oncologist affective behavior, and derived consultation ratios of patient centeredness, patient directedness, and psychosocial focus, were used to predict patient satisfaction with communication post-consultation and at 12-weeks post-consultation. Results Biomedical content categories were predominant in the consultations, accounting for 86% of utterances, followed by administrative (9%) and psychosocial (5%) utterances. Post-consultation satisfaction with communication was significantly lower for patients whose significant others were rated as more assertive during the consultation, and those rated as more anxious during the consultation. Patients who were rated as more anxious during the consultation, those with lower satisfaction with communication immediately post-consultation and those with shorter consultations were significantly less satisfied with communication at 12-weeks post-consultation. Conclusions Adjuvant treatment consultations in prostate oncology are characterized by a high degree of information-giving by the physician, a predominance of biomedical discussion, and relatively minimal time addressing patients' psychosocial concerns. Patients may benefit from oncologists who address anxiety and emotional distress during the primary treatment consultation, allowing sufficient time to ensure that patients leave the consultation with their communication needs having been satisfied. Copyright (c) 2011 John Wiley & Sons, Ltd.