Feldman-Stewart D, Brundage M D, Hayter C, Groome P, Nickel J C, Downes H, Mackillop W J
Radiation Oncology Research Unit, Queen's University, Kingston Regional Cancer Centre, and Kingston General Hospital, Ontario, Canada.
Radiother Oncol. 1998 Nov;49(2):111-23. doi: 10.1016/s0167-8140(98)00091-7.
This study was designed to determine what questions health-care professionals think should be addressed with curable prostate cancer patients before treatment decisions are made.
A survey was distributed to radiation oncologists, urologists, medical oncologists, nurses and radiation therapy technologists (RTTs) involved in treating prostate cancer patients. Participants were asked to judge the importance of addressing each of 78 questions (essential/important/no opinion/avoid) with a described hypothetical patient prior to the treatment decision. Eighty participants were later selected at random for a retest.
The overall response rate was 55% (284/518) on the initial survey and 56% (45/80) on the retest. The relative importance of the various questions was similar across groups (r(76) ranged from 0.75 to 0.91, all P<0.001). Despite the between-group similarity, opinions within each group varied widely. For example, among oncologists, the number of questions deemed essential by individual respondents ranged from five to 69, with >90% respondent agreement on only 15 of the 78 questions. The extent of agreement was similar in the other groups. The retest showed that essential and important responses were reasonably stable, i.e. 92% of questions judged essential at one time were judged either essential (58%) or important (34%) at the other time.
Although the relative importance of addressing the various questions appears similar across the professional groups involved in the care of prostate patients, within each profession there seems to be little agreement. The lack of agreement includes both how many questions are essential to address and whether or not most individual questions are essential.
本研究旨在确定医疗保健专业人员认为在做出治疗决策之前，对于可治愈的前列腺癌患者应解决哪些问题。
向参与治疗前列腺癌患者的放射肿瘤学家、泌尿科医生、医学肿瘤学家、护士和放射治疗技术人员（RTTs）发放了一份调查问卷。要求参与者判断在治疗决策之前，针对一名描述的假设患者解决78个问题（必要/重要/无意见/避免）中每一个问题的重要性。随后随机选择80名参与者进行重新测试。
初始调查的总体回复率为55%（284/518），重新测试的回复率为56%（45/80）。各组对各种问题的相对重要性相似（r(76)范围从0.75至0.91，所有P<0.001）。尽管组间相似，但每组内部的意见差异很大。例如，在肿瘤学家中，个别受访者认为必要的问题数量从5个到69个不等，在78个问题中只有15个问题有>90%的受访者达成一致。其他组的一致程度类似。重新测试表明，必要和重要的回答相当稳定，即一次被判断为必要的问题中有92%在另一次被判断为必要（58%）或重要（34%）。
尽管在参与前列腺患者护理的专业群体中，解决各种问题的相对重要性似乎相似，但在每个专业内部似乎几乎没有达成一致。缺乏一致意见既包括需要解决多少问题是必要的，也包括大多数个别问题是否必要。
