Henselmans Inge, de Haes Hanneke C J M, Smets Ellen M A
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
Psychooncology. 2013 May;22(5):961-77. doi: 10.1002/pon.3099. Epub 2012 May 14.
Because of the complexity of cancer consultations, the contribution of patients is often limited. This systematic review examined the characteristics and effectiveness of patient-targeted interventions that aim to enhance cancer patients' participation in the consultation.
Relevant studies were selected by a search of databases until mid-2010 (Pubmed, PsycINFO and CINAHL), citations in relevant reviews as well as backward/forward citations. A Best Evidence Synthesis was performed, taking into account the quality of studies.
A total of 52 publications were included, describing 46 studies and 30 unique interventions. One-third was delivered through either written or multimedia material, two-thirds face to face. Most originated from English-speaking countries. Half targeted heterogeneous cancer populations, one-third targeted women with breast cancer. Half focussed on initial treatment-planning consultations. Overall, there was evidence for an effect on observed patient participation. There was no evidence for an effect on patient or doctor satisfaction and insufficient evidence for an effect on psychological well-being, physical well-being and consultation duration. The findings turned out to be largely independent of study quality.
Effect of the interventions could only be demonstrated for immediate outcomes, that is, behaviour observed in the consultation. Implications for future research are discussed, including attention for gaps in the literature as well as the choice of outcome measures.
由于癌症会诊的复杂性，患者的贡献往往有限。本系统评价考察了旨在提高癌症患者会诊参与度的针对患者的干预措施的特点和效果。
通过检索数据库（截至2010年年中，检索了PubMed、PsycINFO和CINAHL）、相关综述中的参考文献以及参考文献的前后文引用，筛选出相关研究。在考虑研究质量的基础上进行了最佳证据综合分析。
共纳入52篇文献，描述了46项研究和30种独特的干预措施。三分之一是通过书面材料或多媒体材料实施的，三分之二是面对面实施的。大多数研究来自英语国家。一半的研究针对的是异质性癌症人群，三分之一针对的是乳腺癌女性患者。一半的研究聚焦于初始治疗计划会诊。总体而言，有证据表明干预措施对观察到的患者参与度有影响。没有证据表明对患者或医生满意度有影响，也没有足够证据表明对心理健康、身体健康和会诊时长有影响。研究结果在很大程度上与研究质量无关。
干预措施的效果仅在即时结果方面得到证实，即在会诊中观察到的行为。讨论了对未来研究的启示，包括关注文献中的空白以及结局指标的选择。
