Jansen Jesse, Butow Phyllis N, van Weert Julia C M, van Dulmen Sandra, Devine Rhonda J, Heeren Thea J, Bensing Jozien M, Tattersall Martin H N
Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
J Clin Oncol. 2008 Nov 20;26(33):5450-7. doi: 10.1200/JCO.2007.15.2322. Epub 2008 Oct 20.
To examine age- and age-related differences in recall of information provided during oncology consultations.
Two hundred sixty patients with cancer diagnosed with heterogeneous cancers, seeing a medical or radiation oncologist for the first time, participated in the study. Patients completed questionnaires assessing information needs and anxiety. Recall of information provided was measured using a structured telephone interview in which patients were prompted to remember details physicians gave about diagnosis, prognosis, and treatment. Recall was checked against the actual communication in audio-recordings of the consultations.
Recall decreased significantly with age, but only when total amount of information presented was taken into account. This indicates that if more information is discussed, older patients have more trouble remembering the information than younger ones. In addition, recall was selectively influenced by prognosis. First, patients with a poorer prognosis recalled less. Next, the more information was provided about prognosis, the less information patients recalled, regardless of their actual prognosis.
Recall is not simply a function of patient age. Age only predicts recall when controlling for amount of information presented. Both prognosis and information about prognosis are better predictors of recall than age. These results provide important insights into intervention strategies to improve information recall in patients with cancer.
研究肿瘤会诊期间所提供信息的回忆方面的年龄差异及与年龄相关的差异。
260例首次就诊于医学肿瘤学家或放射肿瘤学家的、被诊断患有不同类型癌症的癌症患者参与了本研究。患者完成了评估信息需求和焦虑的问卷。通过结构化电话访谈来测量所提供信息的回忆情况,在访谈中促使患者回忆医生给出的关于诊断、预后和治疗的细节。将回忆情况与会诊录音中的实际交流内容进行核对。
回忆情况随年龄显著下降,但这仅在考虑所呈现信息的总量时才成立。这表明,如果讨论的信息更多,老年患者比年轻患者更难记住这些信息。此外,回忆情况受预后的选择性影响。首先,预后较差的患者回忆较少。其次,无论患者的实际预后如何,关于预后提供的信息越多,患者回忆的信息就越少。
回忆不仅仅是患者年龄的函数。年龄仅在控制所呈现信息的量时才预测回忆情况。预后及关于预后的信息比年龄更能预测回忆情况。这些结果为改善癌症患者信息回忆的干预策略提供了重要见解。