1Department of Medicine, Weill Cornell Medicine, New York, New York.
2Center for Research on End-of-Life Care, Weill Cornell Medicine, New York, New York.
J Palliat Med. 2019 Aug;22(8):961-965. doi: 10.1089/jpm.2018.0624. Epub 2019 Feb 6.
Routine imaging ("scan") results contain key prognostic information for advanced cancer patients. Yet, little is known about how accurately patients understand this information, and whether psychological states relate to accurate understanding. To determine if patients' sadness and anxiety, as well as results showing poorer prognosis, are associated with patients' understanding of scan results. Archival contrasts performed on multi-institutional cohort study data. Advanced cancer patients whose disease progressed after at least one chemotherapy regimen ( = 94) and their clinicians ( = 28) were recruited before an oncology appointment to discuss routine scan results. In preappointment structured interviews, patients rated sadness and anxiety about their cancer. Following the appointment, patients and clinicians reported whether the imaging results discussed showed progressive, improved, or stable disease. Overall, 68% of patients reported their imaging results accurately, as indicated by concordance with their clinician's rating. Accuracy was higher among patients whose results indicated improved (adjusted odds ratio [AOR] = 4.12, = 0.02) or stable (AOR = 2.59, = 0.04) disease compared with progressive disease. Patients with greater anxiety were less likely to report their imaging results accurately than those with less anxiety (AOR = 0.09, = 0.003); in contrast, those with greater sadness were more likely to report their results accurately than those with less sadness (AOR = 5.23, = 0.03). Advanced cancer patients with higher anxiety and those with disease progression may need more help understanding or accepting their scan results than others.
常规影像学（“扫描”）结果包含晚期癌症患者的关键预后信息。然而，人们对患者对这些信息的理解程度以及心理状态是否与准确理解相关知之甚少。目的是确定患者的悲伤和焦虑，以及预后较差的结果是否与患者对扫描结果的理解相关。对多机构队列研究数据进行存档对比。招募了至少接受过一次化疗方案后疾病进展的晚期癌症患者（ = 94）及其临床医生（ = 28），在肿瘤学预约前进行常规扫描结果讨论。在预约前的结构化访谈中，患者评估了他们对癌症的悲伤和焦虑程度。预约后，患者和临床医生报告了讨论的影像学结果是否显示疾病进展、改善或稳定。总体而言，68%的患者报告其影像学结果准确，这与他们的临床医生的评估一致。结果显示改善（调整后的优势比 [AOR] = 4.12， = 0.02）或稳定（AOR = 2.59， = 0.04）的患者比进展性疾病患者的准确率更高。与焦虑程度较低的患者相比，焦虑程度较高的患者报告其影像学结果不准确的可能性较小（AOR = 0.09， = 0.003）；相比之下，悲伤程度较高的患者更有可能报告其结果准确，而悲伤程度较低的患者则不太可能报告其结果准确（AOR = 5.23， = 0.03）。焦虑程度较高和疾病进展的晚期癌症患者可能比其他人更需要帮助理解或接受他们的扫描结果。
