McConnell D, Butow P N, Tattersall M H
Medical Psychology Unit, University of Sydney, Australia.
Br J Cancer. 1999 Apr;79(11-12):1782-8. doi: 10.1038/sj.bjc.6690284.
A range of measures have been proposed to enhance the provision of information to cancer patients and randomized controlled trials have demonstrated their impact on patient satisfaction and recall. The current study explored the practice and views of oncologists, surgeons and general practitioners (GPs) with regards to providing patients with consultation audiotapes and summary letters. In stage 1, 28 semi-structured interviews with doctors were conducted to provide qualitative data on which to base a questionnaire. In stage 2, 113 medical oncologists, 43 radiation oncologists, 55 surgeons and 108 GPs completed questionnaires. Only one-third of doctors had ever provided patients with a copy of the letter written to the oncologist or referring doctor, and one-quarter had provided a summary letter or tape. The majority of doctors were opposed to such measures; however, a substantial minority were in favour of providing a letter or tape under certain conditions. More surgeons and GPs (> two-thirds) were opposed to specialists providing a consultation audiotape than oncologists (one-third). Gender, years of experience and attitude to patient involvement in decision-making were predictive of doctors' attitudes. The majority of doctors remain opposed to offering patients personalized information aids. However, practice and perspectives appear to be changing.
人们已经提出了一系列措施来加强向癌症患者提供信息,随机对照试验也证明了这些措施对患者满意度和信息留存率的影响。当前的研究探讨了肿瘤学家、外科医生和全科医生在为患者提供会诊录音带和总结信方面的做法和观点。在第一阶段,对医生进行了28次半结构化访谈,以提供用于编制问卷的定性数据。在第二阶段,113名医学肿瘤学家、43名放射肿瘤学家、55名外科医生和108名全科医生完成了问卷。只有三分之一的医生曾向患者提供写给肿瘤学家或转诊医生的信件副本,四分之一的医生提供过总结信或录音带。大多数医生反对这些措施;然而,相当一部分少数医生赞成在某些条件下提供信件或录音带。与肿瘤学家(三分之一)相比,更多的外科医生和全科医生(超过三分之二)反对专科医生提供会诊录音带。性别、从业年限以及对患者参与决策的态度可以预测医生的态度。大多数医生仍然反对为患者提供个性化信息辅助工具。然而,做法和观点似乎正在发生变化。