Bonacchi A, Toccafondi A, Mambrini A, Cantore M, Muraca M G, Focardi F, Lippi D, Miccinesi G
Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy.
Centro Studi e Ricerca Synthesis, Florence, Italy.
Psychooncology. 2015 Sep;24(9):1124-30. doi: 10.1002/pon.3773. Epub 2015 Feb 17.
Although many studies indicate that the use of complementary and alternative medicine by cancer patients is common and widespread, few studies have focused on unmet needs of patients using complementary therapies (CTs). The aim of the present study was to evaluate, through a quantitative approach, possible associations between the use of CTs and the presence of specific unmet needs in cancer patients.
In six Italian oncology departments, 783 patients were interviewed about CTs use and completed the Needs Evaluation Questionnaire. Patients included in the study had different primary tumor sites and were in different phases of the disease and care process.
At the time of the survey, 38.3% of patients were using one or more types of CTs. According to Needs Evaluation Questionnaire, the use of CTs was associated (p < .05) with the need to be more involved in therapeutic choices (40% vs. 31.7%), the need to have a better dialogue with clinicians (44.4% vs. 37.2%), and the need to have more economic-insurance information in relation to their illness (46.1% vs. 36.4%). Statistical significance was confirmed with multivariable analysis for the last two items, whereas three more needs were associated with the use of CTs after adjustment: to receive more explanation on treatments (46.8% vs. 41.0%), to receive more comprehensible information (38% vs. 31.9%), and to receive more attention from nurses (16% vs. 12.1%).
Our study shows interesting differences regarding perceived needs between cancer patients who use and who do not use CTs. Unmet needs that are more expressed in CTs users should be known and, when possible, could be taken into account to improve both psychosocial interventions in the context of conventional care process and the quality of the relationship between patient and medical and nursing staff.
尽管许多研究表明癌症患者使用补充替代医学很常见且广泛，但很少有研究关注使用补充疗法（CTs）患者未满足的需求。本研究的目的是通过定量方法评估CTs的使用与癌症患者特定未满足需求之间的可能关联。
在意大利的六个肿瘤科室，对783名患者进行了关于CTs使用情况的访谈，并让他们完成需求评估问卷。纳入研究的患者有不同的原发肿瘤部位，处于疾病和护理过程的不同阶段。
在调查时，38.3%的患者正在使用一种或多种类型的CTs。根据需求评估问卷，CTs的使用与更多参与治疗选择的需求（40%对31.7%）、与临床医生进行更好对话的需求（44.4%对37.2%）以及获得更多与疾病相关的经济保险信息的需求（46.1%对36.4%）相关（p < 0.05）。多变量分析证实了后两项的统计学意义，而调整后还有另外三项需求与CTs的使用相关：获得更多关于治疗的解释（46.8%对41.0%）、获得更易懂的信息（38%对31.9%）以及得到护士更多关注（16%对12.1%）。
我们的研究显示了使用和未使用CTs的癌症患者在感知需求方面存在有趣的差异。应了解CTs使用者中更突出的未满足需求，并在可能的情况下加以考虑，以改善传统护理过程中的心理社会干预以及患者与医护人员之间的关系质量。
