Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK.
Division of Population and Behavioural Science, Medical School, University of St Andrews, North Haugh, St Andrews, Fife, KY16 9TF, UK.
Support Care Cancer. 2019 Jun;27(6):2143-2151. doi: 10.1007/s00520-018-4484-7. Epub 2018 Oct 1.
Fears of cancer recurrence (FCR) in patients with breast cancer may develop during radiotherapy. Radiographer communication with their patients may influence early survivorship FCR level.
To investigate the management of emotional talk in patients with breast cancer attending their initial review appointments during radiotherapy and predict FCR at 6-8 weeks follow-up.
A mixed-methods observational study was conducted. Patients (consecutive sample, n = 60) with breast cancer, attending a major Scottish cancer centre, had their first two review appointments with their therapeutic radiographer (TR) audio-recorded. In addition, FCR was assessed (FCR7) at baseline and at 6-8 weeks following their final radiotherapy visit. Two TRs participated. Audio files were coded by the VR-CoDES system to identify emotional cues and therapeutic radiographer (TR) responses. Linear regression models were tested for fit and to identify factors associated with follow-up FCR, i.e. patient cues, responses by TR.
Follow-up FCR was predicted negatively (robust estimator, p = .01) by level of patient emotional talk at the second review session. The provision of space by the TR, at the second session, to enable patients to expand their emotional utterances was also associated, but negatively (p = .01), with follow-up FCR. These effects were maintained after inclusion of covariates: age, treatment received and living conditions.
Patient's emotional expression and TR responses at the second review meeting predicted follow-up FCR. The study shows the effect of communication processes on this specific distress component of the patient's survivorship experience.
NCT02599506.
调查放射治疗期间乳腺癌患者初始放疗复查期间的情绪沟通管理，并预测 6-8 周随访时的癌症复发恐惧（FCR）水平。
采用混合方法观察性研究。对在苏格兰一家主要癌症中心接受治疗的乳腺癌患者（连续样本，n=60）进行了初始放疗复查的前两次预约的放射技师（TR）录音。此外，在最后一次放疗结束后 6-8 周时评估 FCR（FCR7）。两位 TR 参与了研究。使用 VR-CoDES 系统对音频文件进行编码，以识别情绪线索和放射治疗师（TR）的反应。测试线性回归模型以确定与随访 FCR 相关的因素，即患者线索、TR 反应。
随访 FCR 与第二次复查时患者的情绪表达水平呈负相关（稳健估计值，p=0.01）。TR 在第二次访谈中提供空间，让患者扩展情绪表达，这也与随访 FCR 呈负相关（p=0.01）。在纳入年龄、治疗方式和生活条件等协变量后，这些影响仍然存在。
患者在第二次复查时的情绪表达和 TR 反应预测了随访时的 FCR。该研究表明沟通过程对患者生存体验中这一特定困扰因素的影响。
NCT02599506。
