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卫生专业人员对与青少年和青年就骨癌临床试验参与进行沟通的看法。

Health professional perceptions of communicating with adolescents and young adults about bone cancer clinical trial participation.

机构信息

Department of Nursing, Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straw's Lane, Marston Road, Oxford, OX3 0FL, UK.

Centre for Outcomes and Experiences Research in Children's Health, Illness, and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.

出版信息

Support Care Cancer. 2019 Feb;27(2):467-475. doi: 10.1007/s00520-018-4337-4. Epub 2018 Jul 5.

Abstract

PURPOSE

Low recruitment of adolescents and young adults in cancer clinical trials is widely reported and may be linked to limited improvements in survival. Research to date does not adequately explain all underlying reasons for poor trial accrual. This paper reports health professional perceptions of communicating with adolescents and young adults with bone sarcoma about clinical trial participation.

METHODS

This study used narrative inquiry. Findings are reported from thematic analysis of in-depth interviews with 18 multidisciplinary health professionals working in a supra-regional bone and soft tissue sarcoma centre.

RESULTS

Participants described professional expertise, the development of specialist knowledge and skills and strategies used to develop trusting relationships with adolescents and young adults with bone sarcoma. These factors were perceived to facilitate communication about clinical trial participation. Emergent themes were having credibility through expertise of the team, developing specialist communication skills through reflection on practice, having inclusive approaches to education and training about clinical trials, individual communication styles used to form trusting relationships, using a patient-centred approach to connect with adolescents and young adults, creating time needed to form trusting relationships and effective team working.

CONCLUSIONS

We aligned findings of this study with characteristics of patient-physician trust and provide a basis for transferable recommendations. Our findings can be used to inform the development of age-specific, specialist communication skills and highlight health professional education needs about clinical trials. Additional research is needed to explore which elements of team working optimise improved clinical trial participation, in what contexts and why.

摘要

目的

癌症临床试验中青少年和年轻人的招募率低已被广泛报道,这可能与生存率的有限提高有关。迄今为止的研究并没有充分解释所有导致试验参与率低的潜在原因。本文报告了医疗专业人员对与患有骨肉瘤的青少年和年轻人就临床试验参与问题进行沟通的看法。

方法

本研究采用叙述性探究。通过对在一个超区域骨和软组织肉瘤中心工作的 18 名多学科医疗专业人员进行深入访谈的主题分析,报告了研究结果。

结果

参与者描述了专业知识、专业知识和技能的发展,以及与患有骨肉瘤的青少年和年轻人建立信任关系的策略。这些因素被认为有助于沟通临床试验参与问题。出现的主题包括通过团队的专业知识获得可信度、通过对实践的反思发展专业沟通技巧、对临床试验进行包容的教育和培训方法、用于建立信任关系的个人沟通风格、采用以患者为中心的方法与青少年和年轻人建立联系、创造建立信任关系所需的时间以及有效的团队合作。

结论

我们将本研究的结果与医患信任的特征进行了对比,并提供了可推广建议的基础。我们的研究结果可用于告知特定年龄的专业沟通技巧的发展,并强调了临床试验方面的医疗专业人员教育需求。需要进一步研究以探讨团队合作的哪些要素能够优化临床试验的参与,以及在什么情况下以及为什么能够优化。

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