All authors: Uppsala University; Lena Ring, Medical Products Agency, Uppsala; Bengt Glimelius, Karolinska Institutet, Stockholm, Sweden.
J Clin Oncol. 2013 Oct 20;31(30):3815-22. doi: 10.1200/JCO.2012.45.1609. Epub 2013 Sep 16.
To explore oncologists' psychosocial attitudes and beliefs and their perceptions regarding barriers against psychosocial communication.
A questionnaire was distributed to oncologists in Sweden (n = 537). Questions covered demography, the Physician Psychosocial Beliefs Scale (PPBS), and barriers against psychosocial communication. Stepwise multiple regression was used to determine what factors contribute the most to the PPBS score and the total number of barriers and barriers affecting clinical practice, respectively. Spearman rank-order correlation was used to determine correlation between PPBS score and number of barriers.
Questionnaire response rate was 64%. Mean PPBS value was 85.5 (range, 49 to 123; SD, 13.0). Most oncologists (93%) perceived one or more barriers in communicating psychosocial aspects with patients. On average, five different communication barriers were perceived, of which most were perceived to affect clinical practice. These barriers included insufficient consultation time, lack of resources for taking care of problems discovered, and lack of methods to evaluate patients' psychosocial health in clinical practice. There was a positive correlation (rs = 0.490; P < .001) between the PPBS score and the number of perceived barriers (ie, less psychosocially oriented oncologists perceived more barriers). Oncologists with supplementary education with a psychosocial focus perceived fewer barriers/barriers affecting clinical practice (P < .001 and P = .001, respectively) and were more psychosocially oriented (P = .001).
Oncologists perceive many different barriers affecting psychosocial communication in clinical practice. Interventions aiming to improve psychosocial communication must therefore be multifaceted and individualized to clinics and individual oncologists. It is important to minimize barriers to facilitate optimal care and treatment of patients with cancer.
探讨肿瘤学家的心理社会态度和信念,以及他们对心理社会沟通障碍的看法。
向瑞典的肿瘤学家(n=537)发放问卷。问题涵盖人口统计学、医生心理社会信念量表(PPBS)以及心理社会沟通障碍。采用逐步多元回归分析确定哪些因素对 PPBS 评分和总障碍数以及影响临床实践的障碍数的贡献最大。采用 Spearman 秩相关分析确定 PPBS 评分与障碍数之间的相关性。
问卷回复率为 64%。平均 PPBS 值为 85.5(范围,49 至 123;标准差,13.0)。大多数肿瘤学家(93%)认为在与患者沟通心理社会方面存在一个或多个障碍。平均有五种不同的沟通障碍被认为存在,其中大多数被认为会影响临床实践。这些障碍包括咨询时间不足、缺乏照顾发现问题的资源以及缺乏在临床实践中评估患者心理社会健康的方法。PPBS 评分与感知到的障碍数量之间存在正相关(rs=0.490;P<.001)(即,心理社会导向性较弱的肿瘤学家感知到更多的障碍)。具有心理社会重点补充教育的肿瘤学家感知到的障碍/影响临床实践的障碍较少(P<.001 和 P=.001),并且更具心理社会导向性(P=.001)。
肿瘤学家认为在临床实践中存在许多不同的心理社会沟通障碍。因此,旨在改善心理社会沟通的干预措施必须是多方面的,并且要针对诊所和个体肿瘤学家进行个体化。减少障碍以促进癌症患者的最佳护理和治疗非常重要。