患者、家属和医生对癌症治疗的不同观点：一项定性研究。
Crossing the perspectives of patients, families, and physicians on cancer treatment: A qualitative study.
作者信息
Orri Massimiliano, Sibeoni Jordan, Bousquet Guilhem, Labey Mathilde, Gueguen Juliette, Laporte Cyril, Winterman Sabine, Picard Camille, Nascimbeni Clara, Verneuil Laurence, Revah-Levy Anne
机构信息
Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France.
ECSTRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.
出版信息
Oncotarget. 2017 Mar 28;8(13):22113-22122. doi: 10.18632/oncotarget.12770.
PURPOSE
Patients, family members, and physicians participate in cancer care, but their perspectives about what is helpful during cancer treatment have rarely been compared. The aim of this study was to compare these three perspectives.
METHODS
Multicenter qualitative study (with previously published protocol) based on 90 semi-structured interviews. Participants (purposively selected until data saturation) came from three different subsamples: (i) patients with cancer (n=30), (ii) their relatives (n=30), and (iii) their referring physicians (n=10, interviewed more than once).
RESULTS
Our analysis found 3 main axes (perceived positive effects of cancer treatment, perceived negative effects of cancer treatment, doctor-physician relationship), each composed of 2 main themes. The findings showed that patients, families, and physicians shared the long-term objective of increasing survival (while reducing side effects). However, patients and relatives also pointed out the importance of living with cancer each day and thus of factors helping them to live as well as possible in daily life. The physicians' difficulty in coping with patients' suffering may limit their access to elements that can improve patients' capacity to live as well as possible.
CONCLUSIONS
During cancer treatment (and not only at the end of life), attention should be given to enhancing the capacity of patients to live as well as possible (not only as long as possible) to meet the goals of patient-centered care and satisfy this important need of patients and families.
目的
患者、家庭成员和医生都参与癌症治疗，但他们对于癌症治疗期间哪些因素有帮助的观点很少被比较。本研究的目的是比较这三种观点。
方法
基于90次半结构化访谈的多中心定性研究（采用先前发表的方案）。参与者（经过目的性抽样直至数据饱和）来自三个不同的子样本：（i）癌症患者（n = 30），（ii）他们的亲属（n = 30），以及（iii）他们的转诊医生（n = 10，接受多次访谈）。
结果
我们的分析发现了3个主要维度（癌症治疗的感知积极效果、癌症治疗的感知消极效果、医患关系），每个维度由2个主要主题组成。研究结果表明，患者、家属和医生都认同提高生存率（同时减少副作用）的长期目标。然而，患者和亲属也指出了每天与癌症共存的重要性，以及那些帮助他们在日常生活中尽可能正常生活的因素的重要性。医生在应对患者痛苦方面的困难可能会限制他们获取能够提高患者尽可能正常生活能力的因素。
结论
在癌症治疗期间（而不仅仅是在生命末期），应关注提高患者尽可能正常生活的能力（而不仅仅是尽可能延长生命），以实现以患者为中心的护理目标，并满足患者和家庭的这一重要需求。
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