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在乳腺癌会诊过程中提问:独自就诊还是有人陪同会有不同吗?

Asking questions during breast cancer consultations: does being alone or being accompanied make a difference?

作者信息

Del Piccolo L, Goss C, Bottacini A, Rigoni V, Mazzi M A, Deledda G, Ballarin M, Molino A, Fiorio E, Zimmermann C

机构信息

Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy.

Department of Public Health and Community Medicine, Section of Clinical Psychology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy.

出版信息

Eur J Oncol Nurs. 2014 Jun;18(3):299-304. doi: 10.1016/j.ejon.2014.02.001. Epub 2014 Mar 11.

Abstract

PURPOSE

Companions often accompany patients to cancer consultations. The number of questions asked by patients and companions is an indicator of their active participation. The present study aims to provide first descriptive evidence on the characteristics of unaccompanied and accompanied Italian breast cancer patients that attend the first consultation after surgery and to analyse companions contribution to the type and quantity of questions asked during the consultation.

METHOD

Seventy consultations of female patients with breast cancer were audio taped. Questions were transcribed and coded by content. Companion's questions were also classified in terms of function. Socio-demographic and clinical data, patients' role preference and confidence in decision making measures were gathered for each patient. Post consultation satisfaction with decision and the perceived level of shared decision making were collected either for the patient and the companion.

RESULTS

69% of patients were accompanied, usually by one close family member, either husband or adult child. Non employed or retired patients and those with a preference for passive role in decision making were more likely to be accompanied. Unaccompanied patients and accompanied patients had comparable levels of anxiety, emotional distress and depression and were equally active in asking questions. These levels were far greater than those reported for other cancer patients in the literature. Companions did not increase significantly the number of questions per consultation.

CONCLUSION

Accompanied and non accompanied patients differed more in socio-demographic than clinical characteristics. Companions sustained the patient and shared information without reducing the level of patient involvement.

摘要

目的

患者就诊癌症时通常有陪伴者陪同。患者和陪伴者提出问题的数量是他们积极参与的一个指标。本研究旨在首次提供关于接受手术后续诊的无人陪伴和有人陪伴的意大利乳腺癌患者特征的描述性证据,并分析陪伴者对就诊期间所提问题的类型和数量的影响。

方法

对70例女性乳腺癌患者的就诊过程进行了录音。问题被转录并按内容编码。陪伴者的问题也按功能进行了分类。收集了每位患者的社会人口统计学和临床数据、患者的角色偏好以及对决策措施的信心。收集了患者和陪伴者就诊后对决策的满意度以及对共同决策程度的感知。

结果

69%的患者有人陪伴,通常是一位近亲,丈夫或成年子女。无工作或退休患者以及那些在决策中倾向于被动角色的患者更有可能有人陪伴。无人陪伴的患者和有人陪伴的患者在焦虑、情绪困扰和抑郁水平上相当,提问也同样积极。这些水平远高于文献中报道的其他癌症患者。陪伴者并没有显著增加每次就诊的问题数量。

结论

有人陪伴和无人陪伴的患者在社会人口统计学特征上的差异大于临床特征。陪伴者支持患者并分享信息,同时没有降低患者的参与程度。

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