Boyes A, Newell S, Girgis A, McElduff P, Sanson-Fisher R
Centre for Health Research and Psycho-oncology (CHeRP), Hunter Medical Research Institute, The University of Newcastle and The Cancer Council NSW, Wallsend, Australia.
Eur J Cancer Care (Engl). 2006 May;15(2):163-71. doi: 10.1111/j.1365-2354.2005.00633.x.
This study examined the effectiveness of giving medical oncologists immediate feedback about cancer patients' self-reported psychosocial well-being in reducing those patients' levels of anxiety, depression, perceived needs and physical symptoms. Cancer patients attending one cancer centre for their first visit were allocated to intervention (n = 42) or control (n = 38) groups. All patients completed a computerized survey assessing their psychosocial well-being while waiting to see the oncologist. Intervention patients' responses were immediately scored and summary reports were placed in each patient's file for follow-up. A total of 48 participants (25 intervention and 23 control) completed the survey four times. Intervention patients who reported a debilitating physical symptom at visit 2 were significantly less likely to report a debilitating physical symptom at visit 3 compared with control patients (OR = 2.8, P = 0.04). Reductions in levels of anxiety, depression and perceived needs among intervention patients were not significantly different to control patients. Repeated collection and immediate feedback of patient-reported health information to oncologists has potential to improve patients' symptom control, but has little impact upon emotional well-being, including those at high risk. Future research should consider providing the feedback to other health professionals and patients, and monitor the impact on the process of individual patient care.
本研究考察了向肿瘤内科医生即时反馈癌症患者自我报告的心理社会幸福感,对降低这些患者的焦虑、抑郁、感知需求及身体症状水平的有效性。首次到某癌症中心就诊的癌症患者被分为干预组(n = 42)和对照组(n = 38)。所有患者在等待看肿瘤内科医生时,都完成了一项评估其心理社会幸福感的计算机化调查。干预组患者的回答立即被打分,并将总结报告放入每位患者的病历中以供后续参考。共有48名参与者(25名干预组和23名对照组)完成了四次调查。与对照组患者相比,在第二次就诊时报告有使人衰弱的身体症状的干预组患者,在第三次就诊时报告有使人衰弱的身体症状的可能性显著降低(OR = 2.8,P = 0.04)。干预组患者焦虑、抑郁及感知需求水平的降低与对照组患者相比无显著差异。向肿瘤内科医生重复收集并即时反馈患者报告的健康信息,有可能改善患者的症状控制,但对包括高危患者在内的情绪幸福感影响不大。未来的研究应考虑将反馈提供给其他医疗专业人员和患者,并监测对个体患者护理过程的影响。