Pearce S, Brownsdon A, Fern L, Gibson F, Whelan J, Lavender V
University College London NHS Foundation Trust, London.
Children's and Young People's Cancer Service, University College London Hospitals NHS Foundation Trust, London.
Eur J Cancer Care (Engl). 2018 Nov;27(6):e12476. doi: 10.1111/ecc.12476. Epub 2016 Mar 3.
The reasons why teenagers and young adults (TYA) with cancer do, or do not, participate in clinical trials is not wholly understood. We explored the perceptions and experiences of young people with bone cancer, and health professionals involved in their care, with regard to participation in two clinical trials. We conducted semi-structured interviews using narrative inquiry with 21 young people aged 15-24 years and 18 health professionals. New understandings emerged about perceptions of, and factors that influence participation in, clinical trials. These include perceptions about the importance and design of the clinical trial, communicating with young people in an age-specific manner, using language young people are comfortable with, support from family, peers and specialists in teenage and young adult cancer care. We conclude that addressing these factors may increase acceptability of clinical trials and the trial design for TYA with cancer and ultimately improve their participation. Qualitative research has an important role in making explicit the perceptions and practices that ensure trials are patient-centred, appropriate and communicated effectively to TYA. Translating knowledge gained into routine practice, will go some way in ensuring that the disparities affecting this population are more fully understood.
患有癌症的青少年和青年(TYA)参与或不参与临床试验的原因尚未完全明了。我们探讨了患有骨癌的年轻人以及参与其护理的医疗专业人员对参与两项临床试验的看法和经历。我们采用叙事探究法对21名年龄在15至24岁的年轻人和18名医疗专业人员进行了半结构化访谈。对于临床试验的看法以及影响参与临床试验的因素有了新的认识。这些因素包括对临床试验重要性和设计的看法、以适合特定年龄段的方式与年轻人沟通、使用年轻人易懂的语言、来自家庭、同龄人以及青少年和青年癌症护理专家的支持。我们得出结论,解决这些因素可能会提高临床试验的可接受性以及针对患有癌症的TYA的试验设计,最终提高他们的参与度。定性研究在明确确保试验以患者为中心、合适且能有效与TYA沟通的看法和实践方面具有重要作用。将获得的知识转化为常规实践,将在一定程度上确保对影响这一人群的差异有更全面的理解。