Companion participation in cancer consultations
Companion participation in cancer consultations
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DOI：
10.1002/pon.1225
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发表时间：
2008-03-01
期刊：
影响因子：
3.6
通讯作者：
Gordon, Howard S.
中科院分区：
文献类型：
--
作者：
Street, Richard L.;Gordon, Howard S.
目的：同伴在癌症护理中发挥着重要作用。这项调查比较了无人陪伴患者、陪同患者和同伴在肺癌会诊期间的沟通情况。分析了影响同伴积极参与的因素。方法：参与者包括在弗吉尼亚州南部大型医疗中心就诊的新诊断肺癌患者的无人陪伴患者（N = 48）、陪伴患者（N = 84）和同伴（N = 84）。磋商过程被录音并转录。编码话语包括患者和同伴的积极参与（提出问题、表达担忧和做出断言）以及医生使用促进性沟通。使用混合线性回归来比较有陪伴的患者与其同伴的参与，并确定同伴参与和患者满意度的独立预测因素。结果：同伴加患者参与的组合与无陪伴患者的参与没有差异。同伴参与的模式差异很大，因为几乎一半的互动有相对被动的同伴（不到 40% 的患者加上同伴积极参与），但 33% 的咨询有积极的同伴和被动的患者。不太积极参与的同伴陪同黑人患者，并且从医生那里获得的便利性沟通也相应较少。当同伴和患者的参与水平相似时，患者满意度较低。结论：同伴在肺癌就诊的参与方面差异很大。医生通过建立伙伴关系和支持性沟通来促进同伴参与。黑人患者的同伴不如白人患者活跃，这与其他研究相似，表明黑人患者通常不如白人患者活跃。这种沟通差异可能会导致癌症护理方面的种族差异。版权所有 (C) 2007 John Wiley & Sons, Ltd.
Objective: Companions play an important role in cancer care. This investigation compared the communication of unaccompanied patients, accompanied patients, and companions during lung cancer consultations. Factors affecting the active participation of companions were analyzed.Methods: Participants included unaccompanied patients (N = 48), accompanied patients (N = 84), and companions (N = 84) of newly diagnosed lung cancer patients seen at a large southern VA medical center. The consultations were audiotaped, then transcribed. Coded utterances included patients' and companions' active participation (asking questions, expressing concerns, and making assertions) and physicians' use of facilitative communication. Mixed linear regression was used for comparisons of accompanied patients' participation to that of their companions and to determine the independent predictors of companion participation and patient satisfaction.Results: The combined companion plus patient participation did not differ from the participation of unaccompanied patients. Patterns of companion participation varied greatly as almost half the interactions had a relatively passive companion (contributed to less than 40% of the patient plus companion active participation) but 33% of the consultations had an active companion and passive patient. Companions with less active participation accompanied black patients and received proportionally less facilitative communication from physicians. Patient satisfaction was lower when companion and patient had similar levels of participation.Conclusion: Companions vary greatly in their participation in lung cancer visits. Physicians facilitate companion participation through the use of partnership-building and supportive communication. The companions of black patients were less active than their white counterparts which parallels other research indicating that black patients are often less active than white patients. Such communicative discrepancies could contribute to racial disparities in cancer care. Copyright (C) 2007 John Wiley & Sons, Ltd.