Obstetrics and Gynecology, University of Minnesota, Minneapolis, MN, USA.
Gynecol Oncol. 2010 Nov;119(2):370-5. doi: 10.1016/j.ygyno.2010.06.032. Epub 2010 Jul 31.
Effective patient -clinician communication at diagnosis is important, yet decreased provider time for face-to-face interactions makes traditional paradigms in cancer care difficult. We evaluated the effects of an educational video on patients' distress, cancer knowledge, coping skills and attitudes regarding learning about cancer at the time of ovarian cancer diagnosis.
An educational video was developed in which oncology professionals, women with ovarian cancer, and their relatives discussed cancer information and experiences. Women admitted for initial diagnostic surgical staging for ovarian cancer were randomized to the educational or placebo video. Before and after the video, patients completed measures of (1) ovarian cancer information, (2) emotional distress, (3) learning attitudes, and (4) coping self-efficacy. Outcomes were analyzed for differences in mean change between intervention and placebo groups using t-tests.
Fifty-nine subjects were randomized (30 intervention/29 placebo). The majority were advanced staged, white, insured, high school educated, employed, and rated their disease seriousness as high. Anxiety, general distress and cancer-specific distress were high. Pre-post video: distress and self-efficacy between groups were unchanged, intervention subjects answered more knowledge items correctly (p=0.0004) and developed more negative learning attitudes (p=0.037). Following the educational video, patients who developed more negative attitudes also had increased intrusive thinking (p=0.046), a sign of increased distress.
Video presentation of cancer-related information increases learning under conditions of high distress and disease threat however, it is not without risk for some. Differing information needs may affect women's emotional response under these conditions.
在诊断时进行有效的医患沟通非常重要,但由于医患面对面交流的时间减少,癌症治疗中的传统模式变得困难。我们评估了教育视频对患者在卵巢癌诊断时的痛苦、癌症知识、应对技能和学习态度的影响。
制作了一个教育视频,其中包括肿瘤专业人员、卵巢癌患者及其亲属讨论癌症信息和经验。接受初始诊断性手术分期的卵巢癌患者被随机分配到教育视频或安慰剂视频组。在观看视频前后,患者完成了以下四项措施的评估:(1)卵巢癌信息,(2)情绪困扰,(3)学习态度,(4)应对自我效能感。使用 t 检验分析干预组和安慰剂组之间的平均变化差异。
59 名患者被随机分配(30 名干预组/29 名安慰剂组)。大多数患者分期较晚、白人、有保险、受过高中教育、有工作,且认为疾病严重程度较高。焦虑、一般困扰和癌症特异性困扰程度较高。观看视频前后:两组的困扰和自我效能感没有变化,干预组答对的知识题更多(p=0.0004),产生了更多负面的学习态度(p=0.037)。观看教育视频后,产生更多负面态度的患者侵入性思维也增加(p=0.046),这是困扰增加的迹象。
在高度痛苦和疾病威胁的情况下,通过视频呈现癌症相关信息可以增加学习效果,但这并非没有风险。在这些情况下,不同的信息需求可能会影响女性的情绪反应。