The Influence of Companions and Socio-Demographic Characteristics on Patients' In

描述（由申请人提供）：这项拟议的研究旨在确保癌症患者能够获得他们需要的信息，从而做出明智的决定。研究表明，在门诊就诊时，通过提问积极寻求信息的患者比提问较少的患者获得更多的信息和其他好处。拟议的研究通过系统地观察和分析在先前录制的肿瘤相互作用视频中不同人群（和同伴，如果存在）提出的问题，调查可能与患者信息寻求相关的因素。假设与患者信息寻求相关的因素有：(a)患者的社会人口统计学特征（即年龄、种族、社会经济地位）；(b)同伴的存在和信息寻求模式；(c)与肿瘤学家关系的质量。这项二次分析的数据是作为nci资助的一项大型研究的一部分收集的。数据包括视频记录的互动和来自城市综合癌症中心的患者、同伴和肿瘤学家的人口统计信息（N = 160）。开发并应用了两个初步观测系统；第一个分析了观察到的与肿瘤学家关系的质量，第二个分析了在互动过程中所问问题的频率和内容。一项初步研究（N = 28）的结果表明，a)陪伴者提出的问题比患者多，b)陪伴者与肿瘤学家之间的积极关系与患者提问的频率呈负相关。此外，研究结果表明，老年患者比年轻患者更有可能带一个伴侣，问的问题更少，而黑人患者比白人患者更不可能带一个伴侣。虽然分析系统被发现是有用的，结果是有趣的，小样本量限制了进一步的分析。本研究通过系统地观察和分析整个互动档案（N = 160）来扩展本研究，以调查与患者信息寻求相关的因素。研究结果将有助于肿瘤学家调整他们向所有患者提供信息的方式，而不考虑社会人口统计学特征或同伴的存在。研究结果还将为进一步研究肿瘤相互作用中同伴对患者结果的影响（例如，回忆信息、知情决策和痛苦）提供基础。本研究的目的是：1)观察和分析城市综合性癌症中心门诊肿瘤互动视频中癌症患者的信息寻求模式；2)分析社会人口学特征、互动中的同伴以及与肿瘤科医生关系的质量与患者信息寻求的关系。本研究探讨了可能影响门诊肿瘤学互动中患者信息寻求的因素，包括社会人口统计学特征、互动中的同伴以及与肿瘤学家关系的质量。研究人员将改进一种观察分析仪器，并将其应用于以前在城市综合癌症中心收集的160个记录患者/同伴与肿瘤学家互动的视频数据库。研究结果将帮助肿瘤学家调整他们向不同人群的患者提供信息的方式，从而改善患者获得所需信息的途径，从而对癌症治疗做出明智的决定。

DESCRIPTION (provided by applicant): This proposed research addresses the need to ensure that cancer patients have access to the information they need to make informed decisions. Research shows that patients who actively seek information by asking questions during outpatient encounters receive more information and other benefits than patients who ask fewer questions. The proposed study investigates factors that may be related to patient information seeking by systematically observing and analyzing questions asked by a diverse population of patients (and companions, if present) during previously video recorded oncology interactions. Factors hypothesized to be related to patient information seeking are (a) patient socio-demographic characteristics (i.e., age, race, socioeconomic status); (b) the presence and information seeking patterns of companions; and (c) the quality of the relationship with the oncologist. Data for this secondary analysis were collected as part of a larger NCI-funded study. Data consist of video recorded interactions and demographic information from patients, companions and oncologists at an urban comprehensive cancer center (N = 160). Two preliminary observational systems were developed and applied; the first analyzes the observed quality of the relationship with the oncologist and the second analyzes the frequency and content of questions asked during the interactions. Findings from a pilot study (N = 28) indicate that a) companions ask more questions than patients and b) positive companion-oncologist relationships are negatively related to the frequency of patient questions. Further, findings suggest that older patients are more likely to bring a companion and ask fewer questions than younger patients, and Black patients are less likely to bring a companion than White patients. Although the analytical systems were found to be useful and findings are intriguing, the small sample size limited further analysis. The proposed study extends this research by systematically observing and analyzing the entire archive of interactions (N = 160) to investigate factors related to patient information seeking. Findings will assist oncologists in tailoring the way they provide information to all patients, regardless of socio-demographic characteristics or the presence of companions. Findings will also provide the basis for further research examining the influence of companions in oncology interactions on patient outcomes (e.g., recall of information, informed decision-making and distress). The aims of this proposed research are: 1) To observe and analyze information seeking patterns of cancer patients in previously video recorded outpatient oncology interactions in an urban, comprehensive cancer center; and 2) To analyze the extent to which socio-demographic characteristics, companions in the interaction, and the quality of the relationship with the oncologist are related to patient information seeking. This proposed study investigates factors that may influence patient information seeking during outpatient oncology interactions, including socio-demographic characteristics, companions in the interaction, and the quality of the relationship with the oncologist. Researchers will refine and apply an observational analytical instrument to a data base of 160 video recorded patient/companion-oncologist interactions that were previously collected at an urban comprehensive cancer center. Findings will assist oncologists in tailoring the way they provide information to patients from diverse populations, thereby improving patients' access to the information they need to make informed decisions about their cancer care.