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PCA:前列腺癌,以患者为中心的方法还是两者兼有?

PCA: prostate cancer, patient-centred approach or both?

机构信息

Europa Uomo, Antwerp, Belgium.

出版信息

BJU Int. 2012 Jul;110(1):16-22. doi: 10.1111/j.1464-410X.2011.10859.x. Epub 2012 Jan 11.

DOI:10.1111/j.1464-410X.2011.10859.x
PMID:22233268
Abstract

What's known on the subject? and What does the study add? Several studies have explored patient-specific expectations of prostate cancer management, while others have investigated physicians' perceptions. However, the opinions of both groups have seldom been compared in one study. Therefore, the present study compares the results of two surveys, one among physicians and one among patients, on patient-physician communication and patients' expectations of prostate cancer management. The present review aims to highlight the differences and similarities in opinion on prostate cancer management between physicians and patients. It reflects the most important results of two surveys on patient-specific expectations in prostate cancer management, done among European prostate cancer specialists and patients with prostate cancer. These results are compared with published data. In addition, the authors' opinion on the survey results and on optimal prostate cancer management is included. To evaluate differences and similarities in opinions on and expectations of prostate cancer management between physicians and patients. Two surveys on patient-specific opinions and expectations in prostate cancer management were done in 2011 among European prostate cancer specialists and patients with prostate cancer. Survey results were complemented with existing published data and with the authors' opinion. Most specialists spent 15-29 min on delivering the diagnosis, and about the same amount of time on explaining treatment options. This time was considered insufficient by 35% and 48% of patients, respectively. There was a large discrepancy between physicians' and patients' opinions about the type of provided prognostic and therapeutic information, indicating that patients may not have completely understood this information. Shared decision-making was preferred by both patients and specialists. Treatment efficacy was the most important factor determining treatment choice for both groups, while the physician's opinion or experience also had a great impact on patients' treatment choice. Patient-support groups have an important role in providing relevant information and in exchanging experiences between patients. The supportive role of partners/relatives was more appreciated when discussing treatment options than during diagnosis. Although patients' expectations are generally matched by their caring physician(s), physicians can still improve quality of care by taking adequate time for their patients, by using terminology that is easily understood by patients and by encouraging shared decision-making. A multidisciplinary team may be an important part of the treatment paradigm, with the individual patient's needs and preferences as the centre of care.

摘要

主题已知内容是什么?以及本研究增加了什么内容? 已有多项研究探讨了前列腺癌管理中患者的具体期望,而其他研究则调查了医生的看法。然而,这两个群体的意见很少在一项研究中进行比较。因此,本研究比较了两项调查的结果,一项是医生的调查,另一项是患者的调查,内容是关于医患沟通和患者对前列腺癌管理的期望。本综述旨在强调医生和患者对前列腺癌管理的意见差异和相似之处。它反映了在欧洲前列腺癌专家和前列腺癌患者中进行的两项关于患者特定期望的调查的最重要结果。这些结果与已发表的数据进行了比较。此外,作者还对调查结果和最佳前列腺癌管理提出了看法。 评估医生和患者对前列腺癌管理的意见和期望的差异和相似之处。 2011 年,在欧洲前列腺癌专家和前列腺癌患者中进行了两项关于患者特定意见和期望的调查。调查结果补充了现有的已发表数据和作者的意见。大多数专家在诊断时花费 15-29 分钟,在解释治疗方案上花费的时间大致相同。分别有 35%和 48%的患者认为这段时间不足。医生和患者对提供的预后和治疗信息类型的看法存在很大差异,表明患者可能没有完全理解这些信息。医患双方都更喜欢共同决策。治疗效果是两组患者决定治疗方案的最重要因素,而医生的意见或经验对患者的治疗选择也有很大影响。患者支持小组在提供相关信息和患者之间交流经验方面发挥着重要作用。在讨论治疗方案时,伴侣/亲属的支持作用比诊断时更受重视。尽管患者的期望通常与他们的主治医生相匹配,但医生可以通过为患者提供足够的时间、使用患者容易理解的术语以及鼓励共同决策来提高护理质量。多学科团队可能是治疗模式的重要组成部分,以患者的需求和偏好为护理中心。

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