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癌症患者与医疗保健提供者之间沟通不畅:症状困扰和患者的披露意愿。

Gaps in communication between cancer patients and healthcare providers: symptom distress and patients' intentions to disclose.

机构信息

Siteman Cancer, Barnes-Jewish Hospital, Washington University School of Medicine, 4921 Parkview Place, MS: 90-35-703, St. Louis, MO, 63110, USA.

School of Medicine, Washington University, Saint Louis, MO, USA.

出版信息

Support Care Cancer. 2019 Jun;27(6):2039-2047. doi: 10.1007/s00520-018-4442-4. Epub 2018 Sep 15.

Abstract

PURPOSE

Good communication between patients and healthcare professionals (HCPs) is an important contributor to patient well-being. Few studies have focused on the gaps in communication between patients and HCPs about symptoms. This study examined patients' perspectives on symptom distress, intention to discuss symptoms, and actual symptom discussion in medical oncology visits.

METHODS

This was a cross-sectional descriptive study. Ninety-four patients provided demographic and clinical information and completed the Memorial Symptom Assessment Scale. Patients also answered questions about their plans for communication-and after the visit, their actual communication-with their medical team about their symptoms.

RESULTS

Patients reported many symptoms by questionnaire; however, they did not plan to discuss-nor actually discussed-most of their symptoms with their HCPs. For all symptoms, fewer than 42% of patients with the symptom intended to discuss it (except for lack of energy and pain) and less than 50% actually discussed the symptom. For bothersome symptoms, less than 42% of those with the symptom intended to discuss it (except for lack of energy) and less than 40% actually discussed the symptom. Psychological symptoms were endorsed by 24-41% of patients, depending on the symptom; however, of those endorsing a symptom, most did not discuss it with an HCP.

CONCLUSIONS

Results of this study support the perception of communication gaps between patients and HCPs about symptoms. Better understanding of these gaps is needed to ensure that patient-centered care is delivered and that patients' symptoms can be appropriately managed in oncology clinics.

摘要

目的

患者与医疗保健专业人员(HCP)之间的良好沟通是患者福祉的重要贡献者。很少有研究关注患者与 HCP 之间关于症状的沟通差距。本研究考察了患者对症状困扰、讨论症状的意愿以及在肿瘤医学就诊中实际讨论症状的看法。

方法

这是一项横断面描述性研究。94 名患者提供了人口统计学和临床信息,并完成了纪念症状评估量表。患者还回答了关于他们与医疗团队沟通计划的问题——就诊后,他们实际与医疗团队沟通了他们的症状。

结果

患者通过问卷报告了许多症状;然而,他们并不打算与 HCP 讨论——也没有实际讨论——他们的大多数症状。对于所有症状,不到 42%的有症状的患者打算讨论(除了缺乏能量和疼痛),不到 50%的患者实际上讨论了症状。对于困扰症状,不到 42%的有症状的患者打算讨论(除了缺乏能量),不到 40%的患者实际上讨论了症状。心理症状的发生率为 24-41%,取决于症状;然而,在那些表示有症状的患者中,大多数患者并未与 HCP 讨论该症状。

结论

本研究的结果支持患者与 HCP 之间在症状沟通方面存在差距的观点。需要更好地了解这些差距,以确保提供以患者为中心的护理,并在肿瘤学诊所中适当管理患者的症状。

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