Arora Neeraj K
Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Blvd., MSC 7344, Bethesda, MD 20892, USA.
Soc Sci Med. 2003 Sep;57(5):791-806. doi: 10.1016/s0277-9536(02)00449-5.
A diagnosis of cancer typically results in patients experiencing uncertainty about and loss of control over their situation, which in turn has a negative influence on their health outcomes. Cancer treatment further disrupts patients' quality of life. Throughout their cancer journey patients often rely on their physicians to provide them with social/interpersonal, informational, and decisional support. A growing body of research shows that physicians' communication behavior does indeed have a positive impact on patient health outcomes. Thus, the patient-physician interaction assumes great significance in the cancer care delivery process. It is encouraging to note that research in this area, largely dominated by studies conducted in primary care, is attracting the attention of cancer researchers. In an attempt to encourage and aid future research on patient-physician communication in cancer care, this paper presents a critical evaluation of existing literature on key elements of physicians' communication behavior (i.e., interpersonal communication, information exchange, and facilitation of patient involvement in decision-making). Different approaches to assessing physician behavior are discussed followed by a review of key findings linking physician behavior with cancer patient health outcomes. Finally, potential limitations of existing research are highlighted and areas for future research are identified.
癌症诊断通常会使患者对自身状况感到不确定且失去控制感，这反过来又会对他们的健康结果产生负面影响。癌症治疗进一步扰乱患者的生活质量。在整个抗癌过程中，患者常常依赖医生为他们提供社会/人际、信息和决策支持。越来越多的研究表明，医生的沟通行为确实对患者的健康结果有积极影响。因此，医患互动在癌症护理过程中具有重要意义。值得欣慰的是，这一领域的研究在很大程度上以初级保健领域的研究为主导，正吸引着癌症研究人员的关注。为了鼓励和推动未来关于癌症护理中医患沟通的研究，本文对有关医生沟通行为关键要素（即人际沟通、信息交流以及促进患者参与决策）的现有文献进行了批判性评估。文中讨论了评估医生行为的不同方法，随后回顾了将医生行为与癌症患者健康结果联系起来的关键研究发现。最后，强调了现有研究的潜在局限性，并确定了未来的研究方向。
