Timothy Gilligan, Cleveland Clinic, Cleveland, OH ; Nessa Coyle, Memorial Sloan Kettering Cancer Center, New York; Ronald M. Epstein, University of Rochester School of Medicine, Rochester, NY; Richard M. Frankel, Regenstrief Institute, Indiana University School of Medicine, Indianapolis, IN; Donna L. Berry and Christopher S. Lathan, Dana-Farber Cancer Institute, Harvard Medical School; Vicki A. Jackson, Massachusetts General Hospital, Harvard Medical School, Boston; Carole Seigel, Patient/Advocacy Representative, Brookline, MA; Kari Bohlke, American Society of Clinical Oncology, Alexandria, VA; Esme Finlay, University of New Mexico School of Medicine, Albuquerque, NM; Charles L. Loprinzi, Mayo Clinic, Rochester, MN; and Lynne H. Nguyen and Walter F. Baile, The University of Texas MD Anderson Cancer Center, Houston, TX.
J Clin Oncol. 2017 Nov 1;35(31):3618-3632. doi: 10.1200/JCO.2017.75.2311. Epub 2017 Sep 11.
Purpose To provide guidance to oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. Methods ASCO convened a multidisciplinary panel of medical oncology, psychiatry, nursing, hospice and palliative medicine, communication skills, health disparities, and advocacy experts to produce recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, and randomized controlled trials published from 2006 through October 1, 2016. Results The systematic review included 47 publications. With the exception of clinician training in communication skills, evidence for many of the clinical questions was limited. Draft recommendations underwent two rounds of consensus voting before being finalized. Recommendations In addition to providing guidance regarding core communication skills and tasks that apply across the continuum of cancer care, recommendations address specific topics, such as discussion of goals of care and prognosis, treatment selection, end-of-life care, facilitating family involvement in care, and clinician training in communication skills. Recommendations are accompanied by suggested strategies for implementation. Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki .
为肿瘤临床医生提供指导,帮助他们运用有效的沟通方式,优化医患关系、提升医患及患者家庭的幸福感。
美国临床肿瘤学会(ASCO)召集了一个由肿瘤医学、精神病学、护理、姑息治疗、沟通技巧、健康差异和倡导专家组成的多学科小组,制定了相关建议。指南的制定涉及对文献的系统回顾和正式的共识过程。系统回顾重点关注 2006 年至 2016 年 10 月 1 日期间发表的指南、系统评价和荟萃分析以及随机对照试验。
系统综述共纳入 47 篇文献。除了沟通技巧的临床医生培训外,许多临床问题的证据都很有限。建议草案经过两轮共识投票才最终定稿。
除了提供有关核心沟通技巧和适用于癌症治疗全过程的任务的指导外,建议还涉及特定主题,如讨论治疗目标和预后、治疗选择、临终关怀、促进家庭成员参与治疗以及临床医生的沟通技巧培训。每条建议都附有实施建议。更多信息可在美国临床肿瘤学会(ASCO)的支持性护理指南(www.asco.org/supportive-care-guidelines)和 ASCO 指南维基(www.asco.org/guidelineswiki)上获取。