Conversations on Cancer Chemotherapy Cessation in Patients With Advanced Cancer: Qualitative Findings From a Multi-Institutional Study.
Conversations on Cancer Chemotherapy Cessation in Patients With Advanced Cancer: Qualitative Findings From a Multi-Institutional Study.
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DOI：
10.1177/1049909120930710
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Jatoi A
中科院分区：
文献类型：
--
作者：
Stout J;Kumbamu A;Tilburt J;Fernandez C;Geller G;Koenig B;Lenz HJ;Jatoi A
多达20%的肿瘤患者在生命的最后14天内接受化疗。这项研究的特点是病人和癌症临床医生之间的对话化疗停止在设置先进的癌症。这项3个研究中心的研究在实际的临床访视期间捕获了肿瘤学临床医生和癌症患者之间的实时录音访谈。审查了讨论化疗停止的录音，并进行了定性分析。在525份记录中，14份侧重于停止化疗; 14名患者参与了11名不同的临床医生。出现了两种类型的非相互排斥的对话元素：直接和具体的元素，描述了缺乏有效的治疗方案和间接元素。直接元素的一个例子如下：“.你知道这是坚韧.但我觉得你可能需要更多的帮助....我想我们快要停止化疗了.....临终关怀真的很有帮助......”相比之下，第二个对话元素更令人费解：“......移植不是一种选择，手术也不是一种选择......选择...就是吃药...它不能缩小肿瘤....它可能会帮助你活得更久一点。但我担心，如果[你]有避孕药，它仍然是一种治疗，它仍然有副作用。我现在担心如果我把它给你，你是如此虚弱，它会让你变得更糟。谈话内容和化疗停止之间似乎没有明显的关系。关于化疗停止的讨论是复杂的;多种因素似乎会决定是否停止。
As many as 20% of oncology patients receive chemotherapy in the last 14 days of their lives. This study characterized conversations between patients and cancer clinicians on chemotherapy cessation in the setting of advanced cancer. This 3-site study captured real-time, audio-recorded interviews between oncology clinicians and cancer patients during actual clinic visits. Audio-recordings were reviewed for discussion of chemotherapy cessation and were analyzed qualitatively. Among 525 recordings, 14 focused on stopping chemotherapy; 14 patients participated with 11 different clinicians. Two types of non-mutually-exclusive conversations elements emerged: direct and specific elements that described an absence of effective therapeutic options and indirect elements. An example of a direct element is as follows: “… You know this is… always really tough…. But I – I think that you may need more help…. I think we’re close to stopping chemotherapy….. And hospice is really helpful to have in place….” In contrast, the second conversation element was more convoluted: “…transplant is not an option and surgery is not an option….. The options…are taking a pill…. It doesn’t shrink the tumor…. It may help you live a little longer. But I’m worried if [you] had the pill, it’s still a therapy and it still has side effects. I [am] worried if I give it to you now, that you’re so weak, it will make you worse.” No relationship seemed apparent between conversation elements and chemotherapy cessation. Conversations on chemotherapy cessation are complex; multiple factors appear to drive the decision of whether or not to stop.
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影响因子：
5.8
作者：
Tilburt, Jon;Yost, Kathleen J.;Roter, Debra L.
通讯作者：
Roter, Debra L.
影响因子：
--
作者：
Zhang, Baohui;Nilsson, Matthew E.;Prigerson, Holly G.
通讯作者：
Prigerson, Holly G.
影响因子：
2.9
作者：
Funk, Laura M.;Stajduhar, Kelli I.;Williams, Allison
通讯作者：
Williams, Allison
影响因子：
45.3
作者：
Earle, Craig C.;Landrum, Mary Beth;Ayanian, John Z.
通讯作者：
Ayanian, John Z.
影响因子：
--
作者：
Warsame, Rahma;Kennedy, Cassie C.;Tilburt, Jon C.
通讯作者：
Tilburt, Jon C.