Assessing Patient Experience in Cancer Care: An Observational Communication Study

沟通是影响患者满意度、依从性和生活质量的综合癌症治疗的重要组成部分。癌症临床互动中涉及的广泛问题使得交流的主题范围广泛（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，也可能具有挑战性。其中一些主题可能不会在临床互动中常规处理，或者可能需要综合癌症护理团队其他成员的咨询支持。在癌症临床医生、患者和初级保健临床医生之间的沟通研究中，一个经常被忽视的关键因素是描述患者和临床医生之间的实时咨询。这些相互作用提供了丰富的材料，以评估关键的心理社会动态和识别问题，病人发现在他们的护理重要。为了设计优化患者体验的护理系统，临床医生和研究人员理解、欣赏并系统地描述癌症患者与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至关重要。本研究旨在通过观察病人和医生的临床互动，并对他们进行几个月的跟踪，以了解他们的护理效果，从而评估病人在癌症护理中的经历。通过深入描述患者在这些临床互动中的对话和经验，本研究将为基于实践的干预奠定基础，以优化患者与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.