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多学科与一对一设置:临床医生对与前列腺癌患者关系的看法的定性研究。

Multidisciplinary Versus One-on-One Setting: A Qualitative Study of Clinicians' Perceptions of Their Relationship With Patients With Prostate Cancer.

机构信息

Prostate Program Scientific Director's Office, Fondazione Istituto di Ricovera e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan, Italy.

出版信息

J Oncol Pract. 2011 Jan;7(1):e1-5. doi: 10.1200/JOP.2010.000020.

Abstract

PURPOSE

Previous studies indicate that a multidisciplinary approach could be suitable for dealing with the complex issues faced by physicians in the management of prostate cancer; however, few studies have investigated clinicians' perceptions of multidisciplinary care. Our aim was to evaluate clinicians' perceptions of the patient-clinician relationship in a multidisciplinary context, and to compare this with physicians' perceptions of providing care independently.

METHODS

A qualitative observational study was performed in 2009. Three radiation oncologists, three urologists, three medical oncologists and one psychologist from the multidisciplinary clinic (MDC) team at the Prostate Program of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, were interviewed to assess their perceptions of their relationship with the patient.

RESULTS

Clinicians reported that the MDC has advantages regarding providing patients with more accurate information and acquiring information from patients, but a clear preference for a multidisciplinary setting did not emerge. Clinicians reported that in one-on-one examinations (1) they feel more comfortable listening to the patient and more able to manage communication, and that (2) the process of building trust is easier.

CONCLUSION

Clinicians appear to recognize the value of the MDC in terms of effective communication with patients but feel that other aspects of relationship building are hindered in a multidisciplinary setting. Organizational and teamwork issues need to be addressed to optimize the implementation of a multidisciplinary approach.

摘要

目的

既往研究表明,多学科方法可能适用于处理医生在前列腺癌管理中面临的复杂问题;然而,很少有研究调查临床医生对多学科护理的看法。我们的目的是评估临床医生在多学科背景下对医患关系的看法,并将其与医生独立提供护理的看法进行比较。

方法

2009 年进行了一项定性观察研究。意大利米兰国家肿瘤研究所前列腺项目多学科诊所(MDC)团队的 3 名放射肿瘤学家、3 名泌尿科医生、3 名肿瘤内科医生和 1 名心理学家接受了采访,以评估他们对与患者关系的看法。

结果

临床医生报告称,MDC 在为患者提供更准确的信息和从患者处获取信息方面具有优势,但并没有明显倾向于多学科环境。临床医生报告说,在一对一的检查中:(1)他们感到更舒适地倾听患者的意见,更能处理沟通问题,(2)建立信任的过程更容易。

结论

临床医生似乎认识到 MDC 在与患者有效沟通方面的价值,但他们认为在多学科环境中,建立关系的其他方面受到阻碍。需要解决组织和团队合作问题,以优化多学科方法的实施。

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