Gironés Regina
Oncologist, Physician, Medical Oncology Unit, Hospital Lluís Alcanyís, Crta Xàtiva a Silla km 2, 46800, Xàtiva, Valencia, Spain.
J Cancer Educ. 2015 Dec;30(4):766-73. doi: 10.1007/s13187-014-0760-5.
Lung cancer chemotherapy decisions in patients≥70 years old are complex. To assess the modes of communication with older lung cancer patients, we prospectively collected data. We assessed patients' level of knowledge about diagnosis and prognosis. Eighty-three patients diagnosed with lung cancer from January 2006 to February 2008 were recruited from a single center. Logistic regression and multiple imputation methods were used to assess associations between patient information and independent variables. Families received the diagnosis of lung cancer (92.8%). Family was more protective when the patients were elderly (p 0.036), depressed (p 0.054), had dementia (p 0.03), had poor performance status (p 0.03), or complied with frailty criteria (p 0.014). Physicians who gave cancer diagnoses were not oncologists and they usually gave cancer diagnosis preferably to family members. Only 27.7% of patients were informed that they had tumors. A 73.5% of patients actively solicited information; however, elderly and frail patients tended to do so less. A large proportion of elderly lung cancer patients do not receive adequate information about their disease prior to contact with oncologists. However, they do actively ask for information and speak about cancer with oncologists.
70岁及以上肺癌患者的化疗决策很复杂。为了评估与老年肺癌患者的沟通方式,我们前瞻性地收集了数据。我们评估了患者对诊断和预后的了解程度。2006年1月至2008年2月期间,从单一中心招募了83名被诊断为肺癌的患者。采用逻辑回归和多重插补方法评估患者信息与自变量之间的关联。家属知晓肺癌诊断情况的占92.8%。当患者年龄较大(p=0.036)、患有抑郁症(p=0.054)、患有痴呆症(p=0.03)、身体状况较差(p=0.03)或符合虚弱标准(p=0.014)时,家属的保护作用更强。给出癌症诊断的医生并非肿瘤学家,他们通常更倾向于将癌症诊断告知家属。只有27.7%的患者被告知自己患有肿瘤。73.5%的患者主动寻求信息;然而,老年和体弱患者这样做的倾向较低。很大一部分老年肺癌患者在与肿瘤学家接触之前没有得到关于其疾病的充分信息。然而,他们确实会主动询问信息并与肿瘤学家谈论癌症。