Hinchey Jenna, Goldberg Jessica, Linsky Sarah, Linsky Rebecca, Jeon Sangchoon, Schulman-Green Dena
Yale School of Nursing , New Haven, Connecticut.
J Palliat Med. 2016 Mar;19(3):314-7. doi: 10.1089/jpm.2015.0133. Epub 2016 Feb 8.
Discrepancies may exist between what oncologists communicate and what patients understand about their cancer stage and its implications.
We explored patients' ability to identify their stage of breast cancer.
As part of a study testing a cancer self-management intervention we asked women to identify their stage of disease and compared responses to the electronic medical record (EMR) for validation. The sample included women with recently diagnosed nonmetastatic (stage I-III) disease. We calculated descriptive statistics and used logistic regression to examine relationships between knowledge of stage, demographic and clinical variables, and study outcomes. Measurement instruments were the Control Preferences Scale (CPS), Knowledge of Care Options Test (KOCO), Measurement of Transitions Scale (MOT), Medical Communication Competence Scale (MCCS), Chronic Disease Self-Efficacy Scale (CDSE), Uncertainty in Illness Scale (MUIS-C), and Hospital Anxiety and Depression Scale (HADS).
Participants (n = 98) had a mean age of 52.3 years (range 27-72). Per the EMR, 19 participants (19.4%) had stage I breast cancer, 56 (57.1%) had stage II, and 23 (23.5%) had stage III. Of the 28 participants (28.6%) unable to identify their stage of cancer correctly, 11 (39.3%) provided vague responses, 11 (39.3%) reported an incorrect stage, and 6 (21.4%) did not know their stage. Younger age (p = 0.0412) and earlier cancer stage (p = 0.0136) were predictive of correctly identifying stage. Participants who at baseline had a greater knowledge of care options (curative, palliative, and hospice care) were more likely to correctly identify their stage (KOCO, p = 0.0345).
Clinicians should revisit conversations about cancer stage and care options to ensure patients' understanding and support self-management.
肿瘤学家所传达的信息与患者对自身癌症分期及其影响的理解之间可能存在差异。
我们探究了患者识别自身乳腺癌分期的能力。
作为一项测试癌症自我管理干预措施研究的一部分，我们让女性识别自己的疾病分期，并将其回答与电子病历（EMR）进行比对以验证。样本包括近期诊断为非转移性（I - III期）疾病的女性。我们计算了描述性统计数据，并使用逻辑回归分析来研究分期知识、人口统计学和临床变量以及研究结果之间的关系。测量工具包括控制偏好量表（CPS）、护理选择知识测试（KOCO）、过渡测量量表（MOT）、医疗沟通能力量表（MCCS）、慢性病自我效能量表（CDSE）、疾病不确定性量表（MUIS - C）以及医院焦虑抑郁量表（HADS）。
参与者（n = 98）的平均年龄为52.3岁（范围27 - 72岁）。根据电子病历，19名参与者（19.4%）患有I期乳腺癌，56名（57.1%）患有II期，23名（23.5%）患有III期。在28名（28.6%）无法正确识别自己癌症分期的参与者中，11名（39.3%）给出了模糊的回答，11名（39.3%）报告了错误的分期，6名（21.4%）不知道自己的分期。年龄较小（p = 0.0412）和癌症分期较早（p = 0.0136）可预测正确识别分期。在基线时对护理选择（治愈性、姑息性和临终关怀护理）有更多了解的参与者更有可能正确识别自己的分期（KOCO，p = 0.0345）。
临床医生应重新审视关于癌症分期和护理选择的谈话，以确保患者理解并支持自我管理。
