Achimaş-Cadariu P, Iancu M, Kubelac P, Pop F, Braicu I, Vlad C, Oskay-Özcelik G, Sehouli J
Department of Surgery, The Oncology Institute Ion Chiricuţă, Cluj-Napoca, Romania.
Department of Surgery and Gynecologic Oncology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Eur J Cancer Care (Engl). 2017 Nov;26(6). doi: 10.1111/ecc.12566. Epub 2016 Aug 10.
We have investigated a relational model of expectations and preferences among ovarian cancer patients centred on physician-patient communication, treatment approach, and the need for information. Consecutive patients anonymously filled in the EXPRESSION III questionnaire between 2009 and 2012. Following descriptive statistics, structural equation modelling was used to analyse the relationships between physician's evaluation by the patient (PEP), result of therapy (RT), need for changes in treatment (NCT) and patient's desire to be informed (PD). From a total of 108 patients, 53 (49.1%) knew their disease stage, 103 (95.4%) underwent surgery, 91 (84.3%) had chemotherapy and 51 (46.3%) relapsed. The final model demonstrated a good fit of data with fit indices >0.90. There was a significant positive effect of PEP on RT and a significant negative effect of PEP on NCT, with the final model explaining 84% of the NCT variance. Physicians represent the main point of contact, not only as a source of information about the disease and various treatment options, but also in the coping processes. As patients benefit from completeness of medical consultations, their awareness of the treatment outcome increases, while a negative perception of the physician leads to a desire to make changes in therapy.
我们研究了以医患沟通、治疗方法和信息需求为核心的卵巢癌患者期望与偏好的关系模型。2009年至2012年期间,连续的患者匿名填写了EXPRESSION III问卷。在进行描述性统计之后,使用结构方程模型分析患者对医生的评价(PEP)、治疗结果(RT)、治疗变更需求(NCT)和患者的信息需求意愿(PD)之间的关系。在总共108名患者中,53名(49.1%)知道自己的疾病分期,103名(95.4%)接受了手术,91名(84.3%)接受了化疗,51名(46.3%)复发。最终模型显示数据拟合良好,拟合指数>0.90。PEP对RT有显著的正向影响,对NCT有显著的负向影响,最终模型解释了NCT方差的84%。医生是主要的联系点,不仅是疾病和各种治疗选择信息的来源,也是应对过程中的关键。由于患者从全面的医疗咨询中受益,他们对治疗结果的认识会提高,而对医生的负面看法会导致改变治疗的愿望。