Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Germany.
Oncol Res Treat. 2015;38(11):590-5. doi: 10.1159/000441312. Epub 2015 Oct 14.
While psychosocial distress and supportive care needs of young adult cancer patients have been increasingly studied, little knowledge exists about preferences for communicating bad news. We aimed to analyze patients' communication preferences against their actual experiences with regard to doctor-patient interactions.
We surveyed a total of 270 cancer patients with different tumor entities. 3 age groups (young, middle-aged, and elderly) were compared concerning their communication preferences (MPP; Measure of Patients' Preferences questionnaire) and the impact on distress (National Comprehensive Cancer Network Distress Thermometer).
We found no age differences of communication preferences and the content of bad news. A significant difference was found in the dimension 'professional expertise/patient orientation (p < 0.01) which was rated as more important by younger patients. Binary logistic regression showed an impact of 'children' (odds ratio (OR) 0.296; 95% confidence interval (CI) 0.155, 0.563), tumor staging (OR 1.737, 95% CI 1.028, 2.936), and insufficient 'privacy' (OR 0.987; 95% CI 0.978, 0.997) and 'clarity' (OR 1.013; 95% CI 1.002, 1.025) on distress.
Communication preferences related to breaking bad news depend less on age differences than on other variables. Future studies should investigate the long-term impact of ineffective patient-physician communication, taking into account unmet patient preferences in different age groups.
尽管青年癌症患者的心理困扰和支持性护理需求已得到越来越多的研究，但对于交流不良消息的偏好却知之甚少。我们旨在分析患者的沟通偏好与医患互动方面的实际经验。
我们共调查了 270 名患有不同肿瘤实体的癌症患者。比较了 3 个年龄组（青年、中年和老年）在沟通偏好（MPP；患者偏好量表）和对不良消息的影响（国家综合癌症网络困扰温度计）方面的差异。
我们发现沟通偏好和不良消息的内容在年龄方面没有差异。在“专业知识/患者导向”维度上存在显著差异（p<0.01），年轻患者认为该维度更为重要。二元逻辑回归显示，“孩子”（优势比（OR）0.296；95%置信区间（CI）0.155，0.563）、肿瘤分期（OR 1.737，95%CI 1.028，2.936）以及“隐私不足”（OR 0.987；95%CI 0.978，0.997）和“清晰度”（OR 1.013；95%CI 1.002，1.025）对困扰有影响。
与传达不良消息相关的沟通偏好受年龄差异的影响较小，而受其他变量的影响较大。未来的研究应考虑不同年龄组中未满足的患者偏好，调查无效的医患沟通的长期影响。
