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为医学物理学家建立新的临床角色:一项前瞻性 II 期试验。

Establishing a New Clinical Role for Medical Physicists: A Prospective Phase II Trial.

机构信息

Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California.

Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California.

出版信息

Int J Radiat Oncol Biol Phys. 2018 Nov 1;102(3):635-641. doi: 10.1016/j.ijrobp.2018.06.040. Epub 2018 Jul 2.

Abstract

PURPOSE

To investigate a new clinical role for medical physicists in direct patient care with a prospective phase 2 clinical trial.

MATERIALS AND METHODS

Medical physicists participated in the Physics Direct Patient Care (PDPC) protocol, establishing independent professional relationships with radiation oncology patients. After attending a dedicated patient communication training program, medical physicists routinely met with patients for 2 physicist-patient consults to explain the treatment planning and delivery process, review the patient's treatment plan, and answer all technical questions. The first physicist-patient consult took place immediately before the computed tomography simulation, and the second took place immediately before the first treatment. Questionnaires were administered to each patient on the PDPC protocol at 3 time points to assess both anxiety and satisfaction. The first questionnaire was given shortly after the first physicist-patient consult, the second questionnaire was given shortly after the second physicist-patient consult, and the third questionnaire was given after the last treatment appointment, with no associated physicist-patient consult.

RESULTS

The mean patient anxiety score was considered to be low at all questionnaire time points. There was a statistically significant decrease (P < .0001) in anxiety from the simulation time point to the first treatment time point. The mean patient technical satisfaction score was considered to be high at all measurement time points. There was a statistically significant increase (P = .0012) in technical satisfaction from the simulation time point to the first treatment time point. There was a statistically significant decrease (P < .023) in technical satisfaction from the first treatment time point to the last treatment time point.

CONCLUSIONS

Establishing a new clinical role for medical physicists and investigating its effects on patient anxiety and satisfaction have created the foundation for future studies. Based on the results of this trial, the PDPC protocol will be expanded to a larger group of medical physicists, radiation oncologists, and patient disease sites and investigated with a randomized phase 3 clinical trial.

摘要

目的

通过前瞻性 2 期临床试验,研究医学物理学家在直接患者护理方面的新临床角色。

材料与方法

医学物理学家参与了物理直接患者护理(PDPC)方案,与放射肿瘤患者建立了独立的专业关系。在参加专门的患者沟通培训计划后,医学物理学家定期与患者进行 2 次物理学家-患者咨询,以解释治疗计划和交付过程,审查患者的治疗计划,并回答所有技术问题。第一次物理学家-患者咨询在计算机断层扫描模拟前进行,第二次在第一次治疗前进行。PDPC 方案中的每位患者在 3 个时间点接受问卷调查,以评估焦虑和满意度。第一次问卷在第一次物理学家-患者咨询后不久发放,第二次问卷在第二次物理学家-患者咨询后不久发放,第三次问卷在最后一次治疗预约后发放,没有相关的物理学家-患者咨询。

结果

在所有问卷时间点,患者焦虑评分均被认为较低。从模拟时间点到第一次治疗时间点,焦虑程度有统计学显著下降(P<.0001)。患者技术满意度评分在所有测量时间点均被认为较高。从模拟时间点到第一次治疗时间点,技术满意度有统计学显著增加(P=.0012)。从第一次治疗时间点到最后一次治疗时间点,技术满意度有统计学显著下降(P<.023)。

结论

为医学物理学家建立新的临床角色,并研究其对患者焦虑和满意度的影响,为未来的研究奠定了基础。基于该试验的结果,PDPC 方案将扩展到更多的医学物理学家、放射肿瘤学家和患者疾病部位,并进行随机 3 期临床试验研究。

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