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早期乳腺癌治疗期间的医患互动:一项国际在线调查结果

Patient-physician interactions during early breast-cancer treatment: results from an international online survey.

作者信息

Lansdown M, Martin L, Fallowfield L

机构信息

Department of Breast Surgery, The General Infirmary, Leeds, UK.

出版信息

Curr Med Res Opin. 2008 Jul;24(7):1891-904. doi: 10.1185/03007990802135042. Epub 2008 May 27.

Abstract

OBJECTIVE

To examine, via an international survey, the impact of positive and negative interactions on the patient-physician relationship.

RESEARCH DESIGN AND METHODS

This online survey was conducted in five countries (USA, UK, Germany, Italy and France) in two populations: (1) postmenopausal women diagnosed with early breast cancer (EBC) in the past 5 years, who had undergone surgery; (2) breast-cancer physicians. The survey covered several topics: patient-physician interactions, EBC treatment options and sources of information.

RESULTS

In total, 462 physicians and 600 patients responded. Most (85%) physicians considered having a good relationship with their patient the most rewarding part of their job. Although 60% of physicians were satisfied with the consultation time (average 17.9 min), 30% considered it insufficient, whilst 49% of patients would prefer more time. Patients reported that physicians were a primary source of information, with 81% indicating that trust in their physician was a vital component of their care. Many physicians (63%) felt that patients are overwhelmed by the amount of information available, but only 16% of patients felt overwhelmed. Most physicians (78%) consider that telling a patient she has EBC is easier than talking about recurrence; 44% rated talking about recurrence as the most stressful part of their job. Most physicians (91%) considered availability of clinical trial data to be crucial for building trust and 74% believed that treatments that minimise recurrence enable more positive conversations.

CONCLUSIONS

Good-quality patient care extends beyond effective treatment to include good communication about therapeutic options, side effects, and the development of trust and confidence. The survey revealed some disparities in physicians' and patients' views, but demonstrated that a strong patient-physician relationship is highly valued by both. Patients need access to accurate information and adequate consultation time. Providing effective and well-tolerated treatments that minimise recurrence may help promote positive interactions.

摘要

目的

通过一项国际调查,研究积极和消极互动对医患关系的影响。

研究设计与方法

这项在线调查在五个国家(美国、英国、德国、意大利和法国)针对两类人群开展:(1)过去5年内被诊断为早期乳腺癌(EBC)且已接受手术的绝经后女性;(2)乳腺癌医生。该调查涵盖多个主题:医患互动、EBC治疗方案及信息来源。

结果

共有462名医生和600名患者回复。大多数(85%)医生认为与患者建立良好关系是其工作中最有意义的部分。尽管60%的医生对会诊时间(平均17.9分钟)感到满意,但30%的医生认为时间不足,而49%的患者希望有更多时间。患者表示医生是主要的信息来源,81%的患者指出对医生的信任是其治疗的关键组成部分。许多医生(63%)认为患者被大量可用信息弄得不知所措,但只有16%的患者有这种感觉。大多数医生(78%)认为告知患者她患有EBC比谈论复发更容易;44%的医生将谈论复发列为工作中最有压力的部分。大多数医生(91%)认为临床试验数据的可获取性对于建立信任至关重要,74%的医生认为将复发风险降至最低的治疗方法能促成更积极的沟通。

结论

优质的患者护理不仅包括有效的治疗,还包括关于治疗方案、副作用以及信任建立的良好沟通。调查揭示了医生和患者观点上的一些差异,但表明良好的医患关系对双方都非常重要。患者需要获取准确信息和充足的会诊时间。提供有效且耐受性良好、能将复发风险降至最低的治疗方法可能有助于促进积极互动。

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