de Araujo Toloi Diego, Critchi Gabriela, Mangabeira Andrea, Matsushita Felipe, Riechelmann Rachel P, Hoff Paulo M, Saad Everardo D
Instituto do Câncer do Estado de São Paulo, Avenida Doutor Arnaldo, 251, São Paulo, Brazil ; Faculdade de Medicina da Universidade de São Paulo, Avenida Doutor Arnaldo, 455, São Paulo, Brazil.
Dendrix Research Ltd, Rua Joaquim Floriano, 72/24, São Paulo, Brazil.
Ecancermedicalscience. 2015 Sep 22;9:574. doi: 10.3332/ecancer.2015.574. eCollection 2015.
Cancer can influence the views of patients on treatment goals and make them different from those of health care professionals (HCPs). It is crucial to understand patient expectations regarding cancer treatment.
We performed a cross-sectional survey of patients with cancer and HCPs to evaluate their perceptions about treatment priorities and to analyse variables that might influence their opinions. To identify treatment choices, we interviewed all participants using a structured questionnaire with fictitious case vignettes.
We enrolled a total of 230 participants, including 144 patients and 86 HCPs (35 nurses, 21 physicians, 30 others). Treatment priority between survival time (28.5% for patients vs. 8.1% for HCP) and quality of life (45.8% vs. 87.2%) differed significantly, with the remaining participants stating they were uncertain or unwilling to respond, or providing invalid responses (P < 0.01). In logistic regression, prioritising survival time was more frequent in patients, adjusting for age and gender (odds ratio (OR) = 3.95; P < 0.01). The view that the physician alone should be responsible for treatment choices was more frequent among patients than HCPs (18.8 vs. 5.8%; P = 0.01).
In Brazil, our results suggest that survival time is more important for patients with cancer than for HCPs, whereas quality of life is more important for HCPs than for patients with cancer, who place great emphasis on physicians as decision-makers. Given that Brazilian patients often rely on physicians for decisions, the potential impact of different priorities between survival time and quality of life when patients and HCPs are compared is unknown.
癌症会影响患者对治疗目标的看法，使其与医护人员（HCPs）的看法不同。了解患者对癌症治疗的期望至关重要。
我们对癌症患者和医护人员进行了一项横断面调查，以评估他们对治疗优先级的看法，并分析可能影响其观点的变量。为了确定治疗选择，我们使用包含虚拟病例 vignettes 的结构化问卷对所有参与者进行了访谈。
我们共招募了 230 名参与者，包括 144 名患者和 86 名医护人员（35 名护士、21 名医生、30 名其他人员）。生存时间（患者为 28.5%，医护人员为 8.1%）和生活质量（45.8% 对 87.2%）之间的治疗优先级存在显著差异，其余参与者表示他们不确定或不愿意回答，或提供无效回答（P < 0.01）。在逻辑回归中，在调整年龄和性别后，患者中优先考虑生存时间的情况更为常见（优势比（OR）= 3.95；P < 0.01）。认为应由医生独自负责治疗选择的观点在患者中比在医护人员中更为常见（18.8% 对 5.8%；P = 0.01）。
在巴西，我们的结果表明，生存时间对癌症患者比对医护人员更重要，而生活质量对医护人员比对癌症患者更重要，癌症患者非常重视医生作为决策者。鉴于巴西患者通常依赖医生做决定，比较患者和医护人员时生存时间和生活质量之间不同优先级的潜在影响尚不清楚。
