Sørensen J B, Rossel P, Holm S
Department Oncology, National University Hospital, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark.
Br J Cancer. 2004 Jan 26;90(2):328-32. doi: 10.1038/sj.bjc.6601524.
Cancer patients demand a high level of involvement in decisions concerning treatment. Many patients are informed about experimental trials, and especially the first consultation may be crucial for the future communication and treatment process. Patients with nonresectable non-small-cell lung cancer or colorectal cancer informed about experimental chemotherapy completed a questionnaire on satisfaction with the communication process, general attitude towards experimental treatments, the substance of information, and personal contact with the physician following their first consultation in a medical oncology unit. Physicians completed a questionnaire on their perception of the patients' satisfaction. Among 68 physician-cancer patient pairs, 29 patients were informed on chemotherapy in randomised trials and 39 in nonrandomised studies. The general attitude towards experimental treatment was positive or very positive in 71% of patients. Information on the treatment was perceived as completely adequate in 93% of patients informed on randomised and in 67% informed on nonrandomised trials. Physicians underestimated the patients' satisfaction with the overall communication process, the personal contact, the patients' perceived sufficiency of the specific treatment information and their ability to decide on study entry. In conclusion, considerable differences were observed between patients informed about experimental chemotherapy in randomised and nonrandomised trials, both with respect to their perception of how adequate the information on the specific treatments were, and whether it was sufficient for decisions on study entry. This study type effect should be accounted for in future evaluations of communication and patient satisfaction. The data also support the fact that cancer patients have a desire for and ability to understand rather detailed and comprehensive treatment information.
癌症患者要求高度参与有关治疗的决策。许多患者了解试验情况，尤其是首次咨询对于未来的沟通和治疗过程可能至关重要。被告知有实验性化疗的不可切除非小细胞肺癌或结直肠癌患者，在肿瘤内科首次咨询后，完成了一份关于对沟通流程的满意度、对实验性治疗的总体态度、信息内容以及与医生个人接触情况的问卷。医生完成了一份关于他们对患者满意度看法的问卷。在68对医患组合中，29名患者被告知参与随机试验中的化疗，39名患者被告知参与非随机研究中的化疗。71%的患者对实验性治疗的总体态度为积极或非常积极。在被告知参与随机试验的患者中，93%认为治疗信息完全充分；在被告知参与非随机试验的患者中，这一比例为67%。医生低估了患者对整体沟通流程、个人接触、患者认为特定治疗信息是否充分以及他们决定参与研究的能力的满意度。总之，在被告知参与随机和非随机试验的实验性化疗患者之间，在对特定治疗信息充分程度的认知以及该信息是否足以决定参与研究方面，观察到了相当大的差异。在未来对沟通和患者满意度的评估中应考虑这种研究类型效应。这些数据也支持了癌症患者渴望并能够理解相当详细和全面的治疗信息这一事实。
