Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers
Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers
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DOI：
10.1186/1471-2407-13-188
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发表时间：
2013-04-09
期刊：
影响因子：
3.8
通讯作者：
Kravitz, Richard L.
中科院分区：
文献类型：
--
作者：
Hoerger, Michael;Epstein, Ronald M.;Kravitz, Richard L.
背景：关于预后和治疗选择的沟通对于晚期癌症的知情决策至关重要。本文介绍了一项调查，旨在促进沟通和决策肿瘤学家，晚期癌症患者，和他们的careers.Methods/设计：在癌症护理（VOICE）研究的价值和选项是一个国家癌症研究所主办的随机对照试验进行的罗切斯特/布法罗，纽约州和萨克拉门托，加利福尼亚州地区。预计共有40名肿瘤学家、约400名晚期癌症患者及其家人/朋友护理人员（每位患者一名，如有）将入组本研究。根据生态学理论，干预采用双管齐下的方法：肿瘤学家完成涉及标准化患者指导员（SPI）的多方面量身定制的教育干预，患者和护理人员完成指导干预，以促进优先考虑和讨论问题和担忧。随访数据将收集大约每季度长达three years.Discussion：干预假设，以提高以病人为中心的沟通，护理质量和病人的结果。分析将检查干预措施对医生-患者-护理人员沟通（主要结局）、医生-患者关系、对预后的共同理解、患者福祉和卫生服务利用（次要结局）的关键要素的影响。
Background: Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers.Methods/design: The Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years.Discussion: The intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes).