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

描述(由申请人提供)：这项拟议的研究解决了确保癌症患者能够获得他们做出知情决定所需的信息的必要性。研究表明，在门诊期间通过提问主动寻求信息的患者比提问较少的患者获得更多信息和其他好处。这项拟议的研究通过系统地观察和分析不同人群的患者(如果有的话)在先前视频记录的肿瘤学互动中提出的问题来调查可能与寻求患者信息有关的因素。假设与寻求患者信息有关的因素是：(A)患者的社会人口特征(即，年龄、种族、社会经济地位)；(B)同伴的存在和寻求信息的模式；以及(C)与肿瘤学家的关系质量。这项二次分析的数据是作为NCI资助的一项更大规模研究的一部分收集的。数据包括来自城市综合癌症中心的患者、同伴和肿瘤学家的视频互动和人口统计信息(N=160)。开发并应用了两个初步观察系统；第一个系统分析观察到的与肿瘤学家关系的质量，第二个系统分析在互动过程中提出问题的频率和内容。一项初步研究(N=28)的结果表明，a)同伴比病人问更多的问题，b)积极的同伴-肿瘤学家关系与病人提问的频率负相关。此外，研究结果表明，年龄较大的患者比年轻患者更有可能带同伴，问的问题也更少，而黑人患者比白人患者更不可能带同伴。尽管分析系统被发现是有用的，研究结果也很耐人寻味，但样本量小限制了进一步的分析。这项拟议的研究通过系统地观察和分析整个互动档案(N=160)来扩展这项研究，以调查与患者信息寻求相关的因素。这些发现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，信息回忆、知情决策和痛苦)提供基础。这项拟议研究的目的是：1)观察和分析癌症患者在城市综合癌症中心以前录像的门诊肿瘤学互动中的信息寻求模式；2)分析社会人口统计特征、互动中的同伴以及与肿瘤学家的关系质量与患者信息寻求的关系程度。这项拟议的研究调查了在门诊肿瘤学互动中可能影响患者信息寻求的因素，包括社会人口学特征、互动中的同伴以及与肿瘤学家的关系质量。研究人员将改进一种观察性分析仪器，并将其应用于先前在城市综合癌症中心收集的160个视频记录的患者/同伴肿瘤学家互动的数据库中。这些发现将有助于肿瘤学家调整他们向来自不同人群的患者提供信息的方式，从而改善患者获得他们需要的信息的机会，以便他们做出关于癌症治疗的明智决定。

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.