Thavarajah Nemica, McGuffin Merrylee, Di Prospero Lisa, Fitch Margaret, Harth Tamara, Feldman-Stewart Deb, Szumacher Ewa
Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, ON, Canada.
Department of Radiation Therapy, Sunnybrook Odette Cancer Centre, University of Toronto, ON, Canada.
J Med Imaging Radiat Sci. 2015 Jun;46(2):189-196. doi: 10.1016/j.jmir.2014.12.001.
There is currently no consensus regarding the optimal treatment for postprostatectomy prostate cancer patients. The primary objective of this study was to investigate patient opinions regarding the questions that should be discussed between health care professionals and postprostatectomy patients who may require radiation therapy with adjuvant or salvage intent, to help facilitate the decision-making process.
Patients who were consulted for treatment of prostate cancer at the Sunnybrook Odette Cancer Centre and who had undergone a prostatectomy were invited to complete a survey. Respondents were asked to rate the importance of 74 questions that may be important to patients in their situation using a four-point ordinal scale (essential, important, no opinion, and avoid). Questions were grouped into six domains pertaining to diagnosis, decision making, radiation therapy procedures, benefits, side effects, and supportive network. Patients were also asked to list any other additional comments or questions that should be included. Descriptive statistics were calculated for all variables of interest. Chi-square analyses and Fisher exact tests were used to assess differences in numbers of patients choosing the essential response between demographics.
Thirty-one patients agreed to participate and completed the survey. The majority of questions rated as essential or important by patients were from the "understanding my situation and prostate cancer diagnosis" domain, accounting for over 90% of patients. Overall, patients who were over 60, white, had an education of high school or less, and lived more than 10 km away from the cancer centre were more likely to have rated these questions as "important" or "essential." A few additional comments were also listed regarding side effects, prostate-specific antigen levels, further testing, and radiation therapy treatment.
Our study showed that there is wide variability among patients regarding the information that they want and need. Every question in our study was essential to some patients, and there was no question deemed so by the whole group. The information from the study will help in building an educational tool for postprostatectomy patients with prostate cancer and their families.
目前对于前列腺切除术后前列腺癌患者的最佳治疗方法尚无共识。本研究的主要目的是调查患者对于医疗保健专业人员与可能需要辅助性或挽救性放疗的前列腺切除术后患者之间应讨论问题的看法，以帮助促进决策过程。
邀请在桑尼布鲁克奥黛特癌症中心咨询前列腺癌治疗且已接受前列腺切除术的患者完成一项调查。要求受访者使用四点有序量表（必不可少、重要、无意见、应避免）对74个可能对处于他们这种情况的患者很重要的问题的重要性进行评分。问题分为与诊断、决策、放射治疗程序、益处、副作用和支持网络相关的六个领域。还要求患者列出任何其他应包含的额外意见或问题。对所有感兴趣的变量进行描述性统计。使用卡方分析和费舍尔精确检验来评估不同人口统计学特征的患者选择“必不可少”回答的数量差异。
31名患者同意参与并完成了调查。患者评定为必不可少或重要的大多数问题来自“了解我的情况和前列腺癌诊断”领域，占患者总数的90%以上。总体而言，年龄超过60岁、白人、教育程度为高中或以下且居住在距离癌症中心10公里以上的患者更有可能将这些问题评定为“重要”或“必不可少”。还列出了一些关于副作用、前列腺特异性抗原水平、进一步检测和放射治疗的额外意见。
我们的研究表明，患者想要和需要的信息存在很大差异。我们研究中的每个问题对一些患者来说都是必不可少的，而没有一个问题被整个群体认为是这样。该研究的信息将有助于为前列腺切除术后的前列腺癌患者及其家属构建一种教育工具。
