Enhancing Patient-Oncologist Communication

加强患者与肿瘤科医生的沟通

• 批准号: 6744164
• 负责人: James A. Tulsky
• 金额: $ 64.27万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-05-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6744164
• 关键词: audiotape; behavioral /social science research tag; clinical research; clinical trials; communication behavior; computer human interaction; data management; education evaluation /planning; educational resource design /development; empathy; health services research tag; human subject; interactive multimedia; interpersonal relations; longitudinal human study; neoplasm /cancer education; neoplasm /cancer palliative treatment; outcomes research; patient care personnel relations; patient oriented research; physicians; prognosis; psychological aspect of cancer; psychological tests; quality of life; questionnaires

DESCRIPTION (provided by applicant): Communication about cancer treatment challenges patients and physicians as they face the transition from fighting a potentially curable disease to realizing that conventional therapies are no longer effective. Patients often confront intense fear and loss, leading to greater emotional needs than at any other time during treatment. Because oncologists also struggle with this transition, they frequently, yet inadvertently, discourage patients from disclosing emotional concerns and thus miss opportunities to communicate effectively, resulting in greater patient anxiety. Unfortunately, no easily disseminable educational interventions exist to help oncologists overcome these challenges. We propose a randomized, controlled trial testing the efficacy of an interactive CD-ROM based intervention using feedback from the oncologists' own recorded encounters to improve their communication. At baseline of this five-year, two site (Duke and the University of Pittsburgh) study, we will audio record 400 outpatient encounters between oncologists (n=50) and patients with advanced cancer (n=200) as they discuss the transition to palliative care. These digitized recordings will be coded for the oncologists eliciting patients' concerns and responding to emotional content. After baseline assessment, we will randomly assign the oncologists to intervention and control arms. The intervention oncologists each will receive a personalized user-friendly CD-ROM that contains their coded conversations, packaged with related educational material. A technical advisor will encourage and facilitate their use of materials. The control group will not receive the CD-ROM or any other support. Three months later, we will conduct the post-intervention assessment by recording another 400 clinic visits between these same oncologists (intervention and control) and a new sample of patients to measure the intervention impact. Primary outcomes will be the communication behaviors emphasized in the intervention, such as responding to empathic opportunities and eliciting patient concerns. This project will expand the field of oncologist-patient communication by identifying key communication skills that may assist patients through difficult transitions and by creating an easily disseminable intervention to help oncologists implement these skills.

描述（由申请人提供）：关于癌症治疗的沟通对患者和医生提出了挑战，因为他们面临着从对抗潜在可治愈疾病到认识到传统疗法不再有效的转变。患者经常面临强烈的恐惧和失落，导致比治疗期间任何其他时间都更大的情感需求。由于肿瘤科医生也在努力应对这种转变，他们经常（但无意中）阻止患者透露情感担忧，从而错过有效沟通的机会，导致患者更加焦虑。不幸的是，不存在易于传播的教育干预措施来帮助肿瘤学家克服这些挑战。我们提出了一项随机对照试验，测试基于交互式 CD-ROM 的干预措施的功效，该干预措施使用肿瘤学家自己记录的遭遇的反馈来改善他们的沟通。在这项为期五年、两个地点（杜克大学和匹兹堡大学）研究的基线中，我们将音频记录肿瘤科医生 (n = 50) 和晚期癌症患者 (n = 200) 之间讨论向姑息治疗过渡时的 400 次门诊会面。这些数字化录音将被编码，以便肿瘤学家引起患者的担忧并对情感内容做出反应。 基线评估后，我们将随机将肿瘤科医生分配到干预组和对照组。每位干预肿瘤学家都将收到一张个性化的用户友好型 CD-ROM，其中包含他们的编码对话，并附有相关的教育材料。技术顾问将鼓励并促进他们使用材料。对照组将不会收到 CD-ROM 或任何其他支持。三个月后，我们将通过记录这些相同的肿瘤科医生（干预和对照）和新患者样本之间的另外 400 次就诊来进行干预后评估，以衡量干预效果。主要结果将是干预中强调的沟通行为，例如对移情机会的反应和引起患者的担忧。该项目将通过确定可帮助患者度过困难过渡的关键沟通技巧，并创建易于传播的干预措施来帮助肿瘤科医生实施这些技能，从而扩大肿瘤科医生与患者沟通的领域。