Shilling Valerie, Jenkins Valerie, Fallowfield Lesley
Cancer Research UK Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, UK.
Psychooncology. 2003 Sep;12(6):599-611. doi: 10.1002/pon.731.
The provision of adequate information in a clear and sensitive manner can improve cancer patients' experience of care. Satisfaction with the cancer consultation may impact on satisfaction with care in general and adjustment to the disease. This study aims to identify factors that influence patient and clinician satisfaction with the cancer consultation and whether satisfaction can be improved with communication skills training. 160 doctors from 34 UK cancer centres participated. Half were randomized to attend a communication skills training course. Patient satisfaction data are presented at baseline and following a communication skills course or in the case of the control doctors, three months after baseline. Clinicians also rated their satisfaction with the consultations. Overall patient satisfaction was not related to the speciality, seniority or sex of the clinician or patient, site of primary cancer or type of treatment. Satisfaction was related to patients' age, psychological morbidity and, most significantly, satisfaction with the length of wait in clinic. Clinician satisfaction was not related to age, sex or cancer site but clinicians were less satisfied following consultations with patients being treated palliatively. Communication skills training had a non-significant positive effect on patient satisfaction. The subtle benefits of improved communication may be overshadowed by practical problems such as waiting too long to see the doctor, which have an adverse effect on satisfaction.
以清晰且体贴的方式提供充分的信息可以改善癌症患者的就医体验。对癌症会诊的满意度可能会影响总体就医满意度以及对疾病的适应情况。本研究旨在确定影响患者和临床医生对癌症会诊满意度的因素,以及沟通技能培训是否能提高满意度。来自英国34个癌症中心的160名医生参与了研究。其中一半被随机分配参加沟通技能培训课程。患者满意度数据在基线时、参加沟通技能课程之后呈现,对于对照组医生,则在基线后三个月呈现。临床医生也对他们对会诊的满意度进行了评分。总体患者满意度与临床医生或患者的专业、资历、性别、原发癌部位或治疗类型无关。满意度与患者的年龄、心理疾病发病率有关,最重要的是,与对在诊所等待时间的满意度有关。临床医生的满意度与年龄、性别或癌症部位无关,但与接受姑息治疗的患者会诊后,临床医生的满意度较低。沟通技能培训对患者满意度有不显著的积极影响。沟通改善带来的细微益处可能会被诸如等待看病时间过长等实际问题所掩盖,这些问题会对满意度产生不利影响。