Groß Sophie Elisabeth, Nitzsche Anika, Gloede Tristan D, Ansmann Lena, Street Richard, Pfaff Holger, Neumann Melanie, Wirtz Markus, Baumann Walter, Schmitz Stephan, Ernstmann Nicole
Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933, Cologne, Germany,
Support Care Cancer. 2015 Apr;23(4):977-84. doi: 10.1007/s00520-014-2450-6. Epub 2014 Sep 25.
A common phenomenon among cancer patients is a fear of cancer recurrence or cancer progression (FOP). The aim of the present study was to analyze whether the oncologist is able to reduce patients' FOP at the initial clinical interview.
A prospective, longitudinal study included patients who were consulting private-practice oncologists in Germany for the first time. Recruitment was carried out by 44 members of the Professional Organization of Office-Based Hematologists and Oncologists. In the patient surveys, data on colon cancer patients' perceptions of communications with their oncologist and on patient-reported outcomes were collected over a period of 6 months. The present study analyzed the patients' data before their first consultation (T 0) and within 3 days after the first consultation (T 1).
A total of 169 patients agreed to participate in the study. Backwards multiple regression analysis was conducted to determine whether the change (T 0-T 1) in FOP is associated with demographic, medical, or psychosocial determinants, or with the physician-patient communication. A significant association was found between the change in FOP and interruptions to the conversation, the comprehensibility of the information provided, the extent of perceived empathy from the physician, and the patient's social support and family status.
Private social support and the initial medical encounter can help reduce FOP. Particularly, oncologists should ensure that they facilitate the presentation of information in a comprehensible way while avoiding interruptions and that they take particular care of patients with poor social support.
癌症患者中常见的一种现象是对癌症复发或进展的恐惧（FOP）。本研究的目的是分析肿瘤学家在初次临床问诊时是否能够减轻患者的FOP。
一项前瞻性纵向研究纳入了首次在德国私人执业肿瘤学家处就诊的患者。招募工作由44名基层血液学家和肿瘤学家专业组织的成员进行。在患者调查中，收集了结肠癌患者对与肿瘤学家沟通的看法以及患者报告结局的数据，为期6个月。本研究分析了患者首次咨询前（T0）和首次咨询后3天内（T1）的数据。
共有169名患者同意参与研究。进行了反向多元回归分析，以确定FOP的变化（T0 - T1）是否与人口统计学、医学或社会心理决定因素或医患沟通有关。发现FOP的变化与谈话中断、所提供信息的可理解性、从医生那里感受到的同理心程度以及患者的社会支持和家庭状况之间存在显著关联。
私人社会支持和初次医疗接触有助于减轻FOP。特别是，肿瘤学家应确保以可理解的方式促进信息的呈现，同时避免中断，并特别关注社会支持差的患者。
