Duke Cancer Institute, Durham, NC, USA; Division of Hematological Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Patient Educ Couns. 2019 Sep;102(9):1602-1612. doi: 10.1016/j.pec.2019.04.028. Epub 2019 Apr 26.
To identify factors limiting and facilitating patient-centered communication (PCC) in the United States hematology-oncology setting, with a focus on multiple myeloma (MM), given the limited attention to PCC and rapid pace of change that has taken place in this setting.
A literature search was performed from 2007 to 2017 to identify published articles and congress abstracts related to clinician-patient communication and treatment decision-making in oncology. Search results were evaluated by year of publication and disease area. A thematic assessment was performed to identify factors limiting and promoting PCC for patients with MM and other hematologic malignancies.
Of the 6673 publications initially retrieved, 18 exclusively reported findings in patients with hematologic malignancies and were included in this review. We identified three critical, but modifiable, barriers to PCC in the hematologic malignancy setting, including insufficient information exchange, treatment goal misalignment, and discordant role preferences in treatment decision-making. Factors that enhanced interaction quality included educational programs for clinicians and patients.
Patients with MM and other hematologic malignancies experience a distinct set of challenges that may affect PCC.
Clinicians have the opportunity to improve patient care by proactively addressing the identified barriers and implementing strategies demonstrated to improve PCC.
确定美国血液肿瘤学环境中限制和促进以患者为中心的沟通（PCC）的因素，重点关注多发性骨髓瘤（MM），因为目前对 PCC 的关注有限，而且该环境中发生了快速变化。
从 2007 年到 2017 年进行了文献检索，以确定与肿瘤学中临床医生与患者沟通和治疗决策相关的已发表文章和大会摘要。根据发表年份和疾病领域对搜索结果进行了评估。进行了专题评估，以确定限制和促进 MM 患者和其他血液恶性肿瘤患者 PCC 的因素。
最初检索到的 6673 篇出版物中，有 18 篇专门报告了血液恶性肿瘤患者的发现，并纳入了本综述。我们确定了血液恶性肿瘤环境中 PCC 的三个关键但可改变的障碍，包括信息交流不足、治疗目标不一致以及治疗决策中角色偏好不一致。增强互动质量的因素包括临床医生和患者的教育计划。
MM 患者和其他血液恶性肿瘤患者经历了一系列独特的挑战，可能会影响 PCC。
临床医生有机会通过主动解决已确定的障碍和实施已证明可改善 PCC 的策略来改善患者的护理。
