Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg D-79085, Germany.
Patient Educ Couns. 2009 Dec;77(3):391-7. doi: 10.1016/j.pec.2009.09.005. Epub 2009 Oct 1.
This study explored the impact of breast cancer patients' experiences of physician-patient communication and participation in decision making on patient depression and quality of life three and six months after primary treatment.
Participants were 135 German breast cancer patients, recruited within a week after the beginning of treatment. Women were asked to complete a self-administered questionnaire at baseline and three and six months later.
Patients who rated their level of information at baseline as high were less depressed after three (p=.010) and six months (p<.001) and experienced higher quality of life after three (p<.001) and six months (p=.049). Patients who participated as much as they had wanted were more satisfied with the decision making process (p<.001) and had lower depression scores three months later (p=.005). The level of participation itself (passive, collaborative, active) and the treatment type had no impact.
The findings reveal the significance of physician-patient communication and stress the meaning of baseline depression for later adjustment.
A high level of information and tailoring the involvement in decision making to patients' desired level can help patients to better cope with their illness. Physicians should assess and treat depression early in cancer treatment.
本研究探讨了乳腺癌患者在初级治疗后 3 个月和 6 个月时对医患沟通和参与决策的体验对患者抑郁和生活质量的影响。
参与者为 135 名德国乳腺癌患者，在治疗开始后一周内招募。女性被要求在基线和 3 个月和 6 个月后填写一份自我管理的问卷。
基线时自我评估信息水平较高的患者在 3 个月（p=.010）和 6 个月（p<.001）后抑郁程度较低，3 个月（p<.001）和 6 个月（p=.049）后生活质量较高。尽可能参与决策的患者对决策过程的满意度更高（p<.001），3 个月后抑郁评分更低（p=.005）。参与度本身（被动、协作、主动）和治疗类型没有影响。
研究结果揭示了医患沟通的重要性，并强调了基线抑郁对后续调整的意义。
提供高水平的信息并根据患者的期望调整决策参与度，可以帮助患者更好地应对疾病。医生应在癌症治疗早期评估和治疗抑郁。
