Goldvaser Hadar, Milman Yonatan, Dujovni Tal, Stern Anat, Mahamid Muhamad, Hanovich Ekaterina, Zivony Amir, Shochat Tzippy, Yerushalmi Rinat, Gafter-Gvili Anat, Brenner Baruch, Shepshelovich Daniel
Davidoff Center, Rabin Medical Center, Institute of Oncology, Beilinson Hospital, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Clin Pract. 2016 Dec;70(12):1027-1032. doi: 10.1111/ijcp.12909.
Data are lacking regarding the perception of cancer patients' prognosis by physicians who are not oncologists.
This was a multicenter survey of seven university-affiliated hospitals, assessing physicians' perception of the median survival of patients with seven advanced malignancies. The study cohort included physicians from all 73 internal medicine, surgery, emergency medicine and critical care departments in the participating hospitals. Family practitioners were contacted through email. Physicians' specialty, age, professional status and hospital type (secondary vs tertiary) were noted. The primary end-point was defined as the percentage of answers with a pessimistic error of more than a year in perception of prognosis as compared with current literature. The secondary end-point was defined as any pessimistic answer.
Four hundred and eighty-eight physicians filled the questionnaire, including 429 hospital physicians and 59 family practitioners. Perception of prognosis was pessimistic when compared with current literature, with 37% and 59% of the answers meeting the primary and the secondary end-points, respectively. Younger age, resident status and work at a secondary hospital were associated with pessimistic perception (P<.001 for all variables). Pessimistic outlook was similar for all specialties and for most malignancies, including those with considerable cure rates such as Hodgkin's lymphoma and germ cell tumour.
Non-oncologists are considerably over pessimistic regarding their perception of the cancer patients' prognosis. A pessimistic perception of prognosis might cause undertreatment and therefore affect both patients' quality of life and their actual survival. Education regarding cancer therapy and its benefits should be emphasised for non-oncologists involved in cancer patient care.
关于非肿瘤专科医生对癌症患者预后的认知，目前缺乏相关数据。
这是一项针对七家大学附属医院的多中心调查，评估医生对七种晚期恶性肿瘤患者中位生存期的认知。研究队列包括参与医院所有73个内科、外科、急诊科和重症监护科的医生。通过电子邮件联系家庭医生。记录医生的专业、年龄、职业地位和医院类型（二级 vs 三级）。主要终点定义为与当前文献相比，对预后认知存在超过一年悲观误差的答案所占百分比。次要终点定义为任何悲观答案。
488名医生填写了问卷，其中包括429名医院医生和59名家庭医生。与当前文献相比，对预后的认知较为悲观，分别有37%和59%的答案符合主要和次要终点。年轻、住院医师身份以及在二级医院工作与悲观认知相关（所有变量P<.001）。所有专业以及大多数恶性肿瘤的悲观看法相似，包括那些治愈率较高的肿瘤，如霍奇金淋巴瘤和生殖细胞肿瘤。
非肿瘤专科医生对癌症患者预后的认知明显过度悲观。对预后的悲观认知可能导致治疗不足，从而影响患者的生活质量和实际生存期。对于参与癌症患者护理的非肿瘤专科医生，应强调癌症治疗及其益处的教育。
