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识别癌症患者的健康亚组:根治性手术后监测方面的态度和偏好差异。

Identifying subgroups of well-being among patients with cancer: Differences in attitudes and preferences around surveillance after curative-intent surgery.

作者信息

Kelly Elizabeth Palmer, Hyer J Madison, Onuma Amblessed E, Paredes Anghela Z, Tsilimigras Diamantis I, Pawlik Timothy M

机构信息

Department of Surgery, The James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.

Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

出版信息

J Surg Oncol. 2019 Aug;120(2):125-131. doi: 10.1002/jso.25507. Epub 2019 May 20.

Abstract

BACKGROUND

Patient perceptions and preferences related to postoperative surveillance are not yet well defined.

METHODS

A cross-sectional analysis of the surveillance practice preferences and attitudes was undertaken based on subgroups derived from clustering participants for measures of well-being, including financial toxicity, emotional, family/social, and functional well-being.

RESULTS

Among 212 participants, the average age was 58.1 years and most patients were female (57.1%) and white (90.2%). Common malignancies included melanoma/sarcoma (26.4%), thyroid (25.5%), breast (18.9%), gastrointestinal (18.4%), and lung (7.5%) cancer. Respondents within the highest well-being subgroup rated their perception of communication as being the highest more consistently compared with the other well-being subgroups (P = .005). Participants with the highest level of well-being felt more reassured by follow-up appointments (Subgroup 1, Med = 4.00, interquartile range (IQR) = 0.25 vs subgroup 4, Med = 3.75, IQR = 0.73, P = .023). In contrast, patients with the lowest sense of well-being had the highest level of nervousness related to surveillance (subgroup 1, Med = 1.60, IQR = 1.00 vs subgroup 4, Med = 2.20, IQR = 1.15, P < .001). There were no differences in surveillance frequency preferences among different well-being subgroups.

CONCLUSION

Attitudes towards postoperative surveillance varied with regard to perception of provider communication, nervous anticipation, and assuredness depending on overall patient well-being. Providers should attempt to assess patient well-being as part of a tailored approach to postcancer surgery surveillance.

摘要

背景

患者对术后监测的认知和偏好尚未得到明确界定。

方法

基于对参与者进行聚类分析得出的亚组,对监测实践偏好和态度进行横断面分析,这些亚组用于衡量包括经济毒性、情绪、家庭/社会和功能健康在内的健康状况。

结果

在212名参与者中,平均年龄为58.1岁,大多数患者为女性(57.1%)且为白人(90.2%)。常见恶性肿瘤包括黑色素瘤/肉瘤(26.4%)、甲状腺癌(25.5%)、乳腺癌(18.9%)、胃肠道癌(18.4%)和肺癌(7.5%)。与其他健康亚组相比,健康状况最佳亚组的受访者对沟通的认知更为一致地评为最高(P = 0.005)。健康状况最佳的参与者对随访预约更放心(亚组1,中位数 = 4.00,四分位间距(IQR)= 0.25;亚组4,中位数 = 3.75,IQR = 0.73,P = 0.023)。相比之下,健康状况最差的患者对监测的紧张程度最高(亚组1,中位数 = 1.60,IQR = 1.00;亚组4,中位数 = 2.20,IQR = 1.15,P < 0.001)。不同健康亚组在监测频率偏好上没有差异。

结论

根据患者的整体健康状况,对术后监测的态度在对医疗服务提供者沟通的认知、紧张预期和安心程度方面存在差异。医疗服务提供者应尝试评估患者的健康状况,作为癌症手术后监测个性化方法的一部分。

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