Sundaresan Puma, Milross Christopher G, Smith Andrea, Evans Alison, Stockler Martin R, King Madeleine T
The Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Central Coast Cancer Centre, Gosford Hospital, Sydney, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2014 Oct;58(5):625-32. doi: 10.1111/1754-9485.12198. Epub 2014 Jun 19.
Radiotherapy (RT) is an essential and cost-effective cancer treatment. It is underutilised in Australia. Bridging the gap between actual and optimal RT utilisation requires not only provision of adequate RT infrastructure but also an understanding of the factors that influence the extent to which this opportunity for RT is utilised. This study explored factors perceived to affect RT-related decision making by consumers and health professionals (HPs).
Six semi-structured focus groups (FGs) and 13 interviews were conducted at three geographical locations in NSW, Australia (n = 26 consumers and 30 HPs). Audio recordings of FGs and interviews were transcribed verbatim and analysed thematically.
An exhaustive list of issues perceived to affect consumer and HP RT decisions was identified. There were common themes across participant groups and locations. Perceptions of RT and its benefits, as well as accurate communication of the expected benefits and risks of RT, were highlighted as important to decision making. Perceived factors relating to 'inconvenience' of RT were multifaceted and included travel, relocation, accommodation, time away from work and financial challenges. Perceived potential barriers to RT referral included knowledge of RT and RT services, availability of a local or visiting RT service, referrer bias, and the low profile of RT.
Important drivers during RT decisions appear to include the perceived benefit, risks and inconvenience of RT. Underutilisation of RT may also result from multiple barriers at the referrer level. Further research into whether these factors influence actual RT decisions is needed.
放射治疗（RT）是一种重要且具有成本效益的癌症治疗方法。在澳大利亚，其使用未达充分水平。缩小实际与最佳放射治疗使用之间的差距，不仅需要提供充足的放射治疗基础设施，还需要了解影响放射治疗这一机会利用程度的因素。本研究探讨了消费者和医疗专业人员（HPs）认为会影响与放射治疗相关决策的因素。
在澳大利亚新南威尔士州的三个地理位置进行了六个半结构化焦点小组（FGs）讨论和13次访谈（26名消费者和30名医疗专业人员）。焦点小组讨论和访谈的录音被逐字转录并进行主题分析。
确定了一份详尽的被认为会影响消费者和医疗专业人员放射治疗决策的问题清单。各参与群体和地点存在共同主题。对放射治疗及其益处的认知，以及对放射治疗预期益处和风险的准确沟通，被强调为决策的重要因素。与放射治疗“不便之处”相关的感知因素是多方面的，包括出行、搬迁、住宿、工作时间、离开和经济挑战。放射治疗转诊的潜在障碍包括对放射治疗和放射治疗服务的了解、当地或来访放射治疗服务的可及性、转诊医生的偏见以及放射治疗的知名度较低。
放射治疗决策过程中的重要驱动因素似乎包括对放射治疗的感知益处、风险和不便之处。放射治疗使用不足也可能是由于转诊层面的多重障碍导致的。需要进一步研究这些因素是否会影响实际的放射治疗决策。
