Oncol Res Treat. 2018;41(12):769-773. doi: 10.1159/000492390. Epub 2018 Nov 21.
Requesting a second opinion (SO) is common in oncology. The reasons and barriers for patients not seeking an SO have yet been to be investigated. Why do patients have difficulties evaluating their need for an SO and what could be done to minimize these barriers?
A 2-stage qualitative study was conducted. 1) Participants were studied in 3 focus groups (FGs). The participants themselves analyzed and then grouped their statements into defined categories. 2) Results of the FGs were discussed with 7 experts from different professional backgrounds. The interviews were unstructured and detailed in the protocol. The statements underwent thematic analysis.
The following 4 main barriers were identified: 1) state of shock, 2) pressure of time, 3) sense of excessive demands and uncertainty triggered by information overload, 4) fear of jeopardizing the patient-physician relationship. The following 4 main suggestions for minimizing the barriers were identified: 1) written patient information, 2) improvement of communication, 3) patient empowerment (PE), 4) holistic approach.
These barriers incapacitate the patients from evaluating the need for an SO. To minimize the barriers, PE, self-management support and shared decision making is recommended. While the implementation of these concepts advances, patients can be empowered by psycho-oncological assistance.
在肿瘤学中，寻求第二意见（SO）是很常见的。然而，患者不寻求 SO 的原因和障碍尚未得到调查。为什么患者难以评估他们对 SO 的需求，我们可以采取什么措施来尽量减少这些障碍？
进行了两阶段的定性研究。1）参与者在 3 个焦点小组（FG）中进行研究。参与者自己对陈述进行分析，然后将其分类为定义明确的类别。2）将 FG 的结果与来自不同专业背景的 7 名专家进行了讨论。访谈是非结构化的，并在协议中详细说明。陈述进行了主题分析。
确定了以下 4 个主要障碍：1）震惊状态，2）时间压力，3）信息过载引发的过度需求感和不确定性，4）担心危及医患关系。确定了以下 4 个减少障碍的主要建议：1）患者信息书面化，2）改善沟通，3）患者赋权（PE），4）整体方法。
这些障碍使患者无法评估对 SO 的需求。为了尽量减少这些障碍，建议采用 PE、自我管理支持和共同决策。在这些概念的实施进展的同时，可以通过心理肿瘤学援助赋予患者权力。
