How oncologists and their patients with advanced cancer communicate about health-related quality of life
How oncologists and their patients with advanced cancer communicate about health-related quality of life
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DOI：
10.1002/pon.1579
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发表时间：
2010-05-01
期刊：
影响因子：
3.6
通讯作者：
Arnold, Robert M.
中科院分区：
文献类型：
--
作者：
Rodriguez, Keri L.;Bayliss, Nichole;Arnold, Robert M.
目的：描述肿瘤学家与其晚期癌症患者在门诊就诊期间关于健康相关生活质量(HRQOL)交流的内容和频率。方法：我们对2003年至2008年在美国两个大型学术医学中心和一个退伍军人事务医学中心进行的随机对照试验--肿瘤学家-患者接触中的沟通研究试验的录音对话(每个对话都包含肿瘤学家先前发现的预后谈话)的子集进行了编码。患者更有可能是女性(53%)，白人(86%)，已婚(78%)，并拥有一定的大学教育(62%)。大多数肿瘤学家是男性(78%)和怀特(78%)。患者的平均年龄为59岁，肿瘤学家的平均年龄为44岁。每一次接触都包括一些关于HRQOL的讨论，而HRQOL讨论平均占访问时间的25%。HRQOL部分描述了症状(50%)、一般HRQOL(27%)和下列担忧：身体(27%)、功能(22%)、心理(9%)、社交(7%)、精神(1%)和其他(28%)。主题包括治疗(56%)、疾病(14%)和测试(3%)，以及集中在过去(44%)、现在(68%)和未来(59%)的对话。结论：肿瘤学家和患者之间的HRQOL讨论很常见，但即使是晚期疾病患者，讨论的重点往往也是治疗(如副作用)和症状(如疼痛)。考虑到晚期癌症患者通常具有强烈的情感体验，肿瘤学家可能需要更多地关注心理、社会和精神上的HRQOL问题。版权所有(C)2009 John Wiley&Sons，Ltd.
Objective: To describe the content and frequency of communication about health-related quality of life (HRQOL) during outpatient encounters between oncologists and their patients with advanced cancer.Methods: We coded for HRQOL talk in a subset of audio-recorded conversations (each previously found to contain prognostic talk by the oncologist) from the Study of Communication in Oncologist-Patient Encounters Trial, a randomized controlled trial conducted from 2003 to 2008 in two large US academic medical centers and one Veterans Affairs Medical Center.Results: Seventy-three encounters involved 70 patients and 37 oncologists. Patients were more likely to be female (53%), White (86%), married (78%), and possessing some college education (62%). Most oncologists were male (78%) and White (78%). Mean ages were 59 years for patients and 44 years for oncologists. Every encounter included some talk about HRQOL and HRQOL discussions made up, on average, 25% of the visit time. HRQOL segments described symptoms (50%), general HRQOL (27%), and the following concerns: physical (27%), functional (22%), psychological (9%), social (7%), spiritual (1%), and other (28%). Topics included treatment (56%), disease (14%), and testing (3%), and conversations focused on past (44%), present (68%), and future HRQOL (59%).Conclusions: HRQOL discussions between oncologists and patients are common, but the emphasis is often on treatment (e.g. side effects) and symptoms (e.g. pain) even in patients with advanced disease. Given the often intense emotional experience of patients with advanced cancer, oncologists may need to pay more attention to psychological, social, and spiritual HRQOL concerns. Copyright (C) 2009 John Wiley & Sons, Ltd.