参与乳腺癌患者的肿瘤学咨询:一项多中心随机对照试验——INCA 研究方案。
INvolvement of breast CAncer patients during oncological consultations: a multicentre randomised controlled trial--the INCA study protocol.
机构信息
Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Verona, Italy.
出版信息
BMJ Open. 2013 May 2;3(5):e002266. doi: 10.1136/bmjopen-2012-002266.
INTRODUCTION
Studies on patient involvement show that physicians make few attempts to involve their patients who ask few questions if not facilitated. On the other hand, the patients who participate in the decision-making process show greater treatment adherence and have better health outcomes. Different methods to encourage the active participation during oncological consultation have been described; however, similar studies in Italy are lacking. The aims of the present study are to (1) assess the effects of a preconsultation intervention to increase the involvement of breast cancer patients during the consultation, and (2) explore the role of the attending companions in the information exchange during consultation.
METHODS AND ANALYSIS
All female patients with breast cancer who attend the Oncology Out-patient Services for the first time will provide an informed consent to participate in the study. They are randomly assigned to the intervention or to the control group. The intervention consists of the presentation of a list of relevant illness-related questions, called a question prompt sheet. The primary outcome measure of the efficacy of the intervention is the number of questions asked by patients during the consultation. Secondary outcomes are the involvement of the patient by the oncologist; the patient's perceived achievement of her information needs; the patient's satisfaction and ability to cope; the quality of the doctor-patient relationship in terms of patient-centeredness; and the number of questions asked by the patient's companions and their involvement during the consultation. All outcome measures are supposed to significantly increase in the intervention group.
ETHICS AND DISSEMINATION
The study was approved by the local Ethics Committee of the Hospital Trust of Verona. Study findings will be disseminated through peer-reviewed publications and conference presentations.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT01510964.
简介
患者参与度的研究表明,如果没有得到促进,医生很少尝试让主动提问的患者参与其中。另一方面,参与决策过程的患者表现出更高的治疗依从性和更好的健康结果。已经描述了许多鼓励在肿瘤学咨询中积极参与的方法;然而,意大利缺乏类似的研究。本研究的目的是:(1)评估预咨询干预措施对增加乳腺癌患者在咨询期间参与度的效果,以及(2)探讨主治陪同人员在咨询期间信息交流中的作用。
方法和分析
所有首次到肿瘤门诊就诊的女性乳腺癌患者均将获得参与研究的知情同意。他们被随机分配到干预组或对照组。干预措施包括提供一份与疾病相关的问题清单,称为问题提示表。干预的主要疗效指标是患者在咨询期间提出的问题数量。次要结果是肿瘤医生对患者的参与程度;患者对其信息需求的感知达成度;患者的满意度和应对能力;从以患者为中心的角度衡量医患关系的质量;以及患者同伴在咨询期间提出的问题数量及其参与度。预计所有的结果指标在干预组都会显著增加。
伦理和传播
该研究已获得维罗纳医院信托基金当地伦理委员会的批准。研究结果将通过同行评审的出版物和会议报告进行传播。
试验注册
ClinicalTrials.gov 标识符:NCT01510964。