Assessing Patient Experience in Cancer Care: An Observational Communication Study

沟通是全面癌症护理的重要组成部分，影响患者的满意度、依从性和生活质量。癌症临床互动中涉及的广泛问题使人们可以就广泛的话题进行交流(包括生活质量、沟通、症状控制、补充/替代疗法、成本、治疗负担、预后、焦虑、副作用、性功能、姑息治疗选择等)。特别有趣，而且具有潜在的挑战性。这些主题中的一些可能不会在临床互动中常规解决，或者可能需要综合癌症护理团队的其他成员的咨询支持。在研究癌症临床医生、他们的患者和他们的初级保健临床医生之间的沟通时，一个经常被忽视的关键因素是描述患者和他们的临床医生之间的实时会诊。这些互动为评估关键的心理-社会动态和确定患者认为在他们的护理中重要的问题提供了丰富的材料。为了设计优化患者体验的护理系统，临床医生和研究人员了解、理解和系统地描述癌症患者及其治疗临床医生之间常规癌症会诊决策过程的丰富性和复杂性是至关重要的。这项研究试图通过观察患者和他们的医生在临床互动中的情况，并对他们进行几个月的跟踪，看看他们的护理进展情况，来评估患者在癌症护理中的体验。通过深入描述患者在这些临床互动中的对话和经历，本研究将为以实践为基础的干预奠定基础，以优化患者与他们的癌症护理团队的互动。

Communication is an important component of comprehensive cancer care impacting patient satisfaction, adherence, and quality of life. The wide array of issues addressed in cancer clinical interactions makes communicating about a broad range of topics (including quality of life, communication, symptom control, complementary/alternative therapies, costs, treatment burden, prognosis, anxiety, side-effects, sexual function, palliative care options, etc.) especially interesting and potentially challenging. Some of these topics may not be routinely addressed in the clinical interaction or may require consultative support from other members of the comprehensive cancer care team. One frequently overlooked critical element in research on communication between cancer clinicians, their patients, and their primary care clinicians is describing real-time consultations between patients and their clinicians. These interactions provide rich material for assessing key psycho-social dynamics and identifying issues that patients find important in their care. In order to devise systems of care that optimize the patient experience, it is critical that clinicians and researchers understand, appreciate, and systematically characterize the richness and complexity of the decision-making process in routine cancer consultations between cancer patients and their treating clinicians. This study seeks to assess the patient experience in cancer care by observing patients and their physicians in their clinical interactions and following them for several months to see how their care went. By describing in-depth the conversations and experiences of patients in these clinical interactions, this study will lay the foundation for practice-based interventions to optimize patients¿ interactions with their cancer care teams.