Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, ON.
Curr Oncol. 2009 Dec;16(6):42-9. doi: 10.3747/co.v16i6.432.
To develop recommendations for effective communication between cancer health care providers and patients based on a systematic review of methods of clinician-patient communication that may affect patient outcomes associated with distress at critical points in the course of cancer care.
A systematic review of the literature was conducted, and evidence-based recommendations were formulated to guide clinician-patient communication in cancer care. A formal external review was conducted to validate the relevance of these recommendations.
Recommendations for communication in cancer care are presented, based on guidelines from the Australian National Breast Cancer Centre and the Australian National Cancer Control Initiative,an updated systematic review of the research evidence, and a consensus by the Clinician-Patient Communications Working Panel of the Program in Evidence-Based Care of Cancer Care Ontario. The recommendations were sent to 110 Ontario practitioners for external review: 33 responded (30% response rate). Most of these respondents (87%) agreed with the draft recommendations and approved of their use as a practice guideline (90%). A condensed version of the recommendations, including 10 key points, was also created.
There is evidence to support general clinician-patient communication approaches, although the preferences of cancer patients regarding such communication exhibit individual and cultural variability. Recommendations are provided, based on evidence, the consensus of an expert panel, and feedback from a survey of external practitioners. Evidence evaluating the role of decision aids and strategies to facilitate better communication is inconsistent, although such tools may be of value for some patients.
根据对可能影响癌症患者在治疗过程中关键节点的困扰相关结局的临床医生-患者沟通方法的系统评价，制定癌症护理提供者与患者之间有效沟通的建议。
对文献进行系统评价，并制定基于循证的建议以指导癌症护理中的临床医生-患者沟通。进行了正式的外部审查，以验证这些建议的相关性。
根据澳大利亚国家乳腺癌中心和澳大利亚国家癌症控制倡议的指南、对研究证据的最新系统评价以及安大略省癌症护理循证护理计划的临床医生-患者沟通工作组的共识，提出了癌症护理沟通建议。这些建议被发送给安大略省的 110 名从业者进行外部审查：33 人回复（30%的回复率）。这些回应者中的大多数（87%）同意草案建议，并批准将其用作实践指南（90%）。还创建了建议的精简版，其中包括 10 个要点。
有证据支持一般的临床医生-患者沟通方法，尽管癌症患者对这种沟通的偏好表现出个体和文化的差异。这些建议是基于证据、专家小组的共识以及对外部从业者调查的反馈制定的。尽管决策辅助工具和促进更好沟通的策略可能对某些患者有价值，但评估这些工具作用的证据并不一致。
