Rapport Frances, Hogden Anne, Gurney Howard, Gillatt David, Bierbaum Mia, Shih Patti, Churruca Kate
Faculty of Medicine and Health Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
BMJ Open. 2017 Oct 5;7(10):e017372. doi: 10.1136/bmjopen-2017-017372.
One in five men is likely to receive a diagnosis of prostate cancer (PCa) by the age of 85 years. Men diagnosed with low-risk PCa may be eligible for active surveillance (AS) to monitor their cancer to ensure that any changes are discovered and responded to in a timely way. Communication of risk in this context is more complicated than determining a numerical probability of risk, as patients wish to understand the implications of risk on their lives in concrete terms. Our study will examine how risk for PCa is perceived, experienced and communicated by patients using AS with their health professionals, and the implications for treatment and care.
This is a proof of concept study, testing out a multimethod, qualitative approach to data collection in the context of PCa for the first time in Australia. It is being conducted from November 2016 to December 2017 in an Australian university hospital urology clinic. Participants are 10 men with a diagnosis of localised PCa, who are using an AS protocol, and 5 health professionals who work with this patient group (eg, urologists and Pca nurses). Data will be collected using observations of patient consultations with health professionals, patient questionnaires and interviews, and interviews with healthcare professionals. Analysis will be conducted in two stages. First, observational data from consultations will be analysed thematically to encapsulate various dimensions of risk classification and consultation dialogue. Second, interview data will be coded to derive meaning in text and analysed thematically. Overarching themes will represent patient and health professional perspectives of risk communication.
Ethical approval for the study has been granted by Macquarie University Human Research Ethics Committee, approval 5201600638. Knowledge translation will be achieved through publications, reports and conference presentations to patients, families, clinicians and researchers.
到85岁时,五分之一的男性可能会被诊断出患有前列腺癌(PCa)。被诊断为低风险前列腺癌的男性可能适合进行主动监测(AS),以监测其癌症情况,确保及时发现并应对任何变化。在这种情况下,风险沟通比确定风险的数值概率更为复杂,因为患者希望切实了解风险对其生活的影响。我们的研究将探讨使用主动监测的前列腺癌患者如何与医护人员感知、体验和沟通风险,以及对治疗和护理的影响。
这是一项概念验证研究,首次在澳大利亚对前列腺癌背景下的数据收集采用多方法、定性方法进行测试。该研究于2016年11月至2017年12月在澳大利亚一家大学医院的泌尿外科诊所进行。参与者包括10名被诊断为局限性前列腺癌且正在使用主动监测方案的男性,以及5名与该患者群体合作的医护人员(如泌尿科医生和前列腺癌护士)。将通过观察患者与医护人员的会诊、患者问卷调查和访谈以及对医护人员的访谈来收集数据。分析将分两个阶段进行。首先,对会诊的观察数据进行主题分析,以概括风险分类和会诊对话的各个维度。其次,对访谈数据进行编码以提取文本中的意义并进行主题分析。总体主题将代表患者和医护人员对风险沟通的观点。
该研究已获得麦考瑞大学人类研究伦理委员会的伦理批准,批准号为5201600638。将通过向患者、家属、临床医生和研究人员发表文章、报告和进行会议演讲来实现知识转化。