Morgan E R, Laing K, McCarthy J, McCrate F, Seal M D
Department of Medical Oncology, University of Toronto, Toronto, ON;
Cancer Care Program, Eastern Health, St. John's, NL;
Curr Oncol. 2015 Oct;22(5):e364-9. doi: 10.3747/co.22.2476.
Patient education in early-stage breast cancer has been shown to improve patient well-being and quality of life, but it poses a challenge given the increasingly complex regimens and time constraints in clinical practice. Technology-aided teaching in the clinic could help to improve the understanding of adjuvant systemic therapy for patients. In this prospective pilot study, we used a clinician-administered, tablet-based teaching aid to teach patients with early-stage breast cancer about adjuvant systemic therapy.
Participation was offered to newly diagnosed patients with early-stage breast cancer presenting for their first medical oncology visit at a provincial cancer centre. Participants were shown a tablet-based presentation describing procedures, rationales, risks, and benefits of adjuvant systemic therapy as an adjunct to a discussion with the medical oncologist. After the clinic visit, participants completed a questionnaire measuring satisfaction with the visit and knowledge of the treatment plan discussed.
The 25 patients recruited for the study had a mean age of 57 years. An offer of upfront chemotherapy alone was made to 12 participants (48%), chemotherapy with trastuzumab to 4 (16%), and hormonal therapy to 9 (36%). Correct answers to all questions related to treatment knowledge were given by 22 patients (88%). Satisfaction with the clinic visit was high (mean satisfaction score: 4.53 ± 0.1 of a possible 5).
We found that a tablet-based presentation about adjuvant systemic therapy was satisfactory to patients with early-stage breast cancer and that knowledge retention after the clinic visit was high. Tablet-based teaching could be a feasible and effective way of educating patients in the breast oncology clinic and warrants further investigation in randomized studies.
早期乳腺癌患者教育已被证明可改善患者的幸福感和生活质量，但鉴于临床实践中治疗方案日益复杂且时间有限，这带来了挑战。临床中借助技术辅助教学有助于提高患者对辅助性全身治疗的理解。在这项前瞻性试点研究中，我们使用了由临床医生操作的基于平板电脑的教学辅助工具，向早期乳腺癌患者传授辅助性全身治疗知识。
邀请新诊断的早期乳腺癌患者参加省级癌症中心的首次肿瘤内科就诊。在与肿瘤内科医生讨论的同时，向参与者展示基于平板电脑的演示文稿，内容包括辅助性全身治疗的程序、原理、风险和益处。门诊就诊后，参与者完成一份问卷，评估对此次就诊的满意度以及对所讨论治疗方案的了解程度。
该研究招募的25名患者平均年龄为57岁。12名参与者（48%）仅接受了 upfront 化疗，4名（16%）接受了化疗联合曲妥珠单抗，9名（36%）接受了激素治疗。22名患者（88%）对所有与治疗知识相关的问题回答正确。对门诊就诊的满意度较高（平均满意度得分：4.53 ± 0.1，满分5分）。
我们发现，关于辅助性全身治疗的基于平板电脑的演示文稿对早期乳腺癌患者来说是令人满意的，且门诊就诊后的知识保留率较高。基于平板电脑的教学可能是乳腺肿瘤门诊教育患者的一种可行且有效的方式，值得在随机研究中进一步探究。
