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患者定义的治疗成功:晚期肺癌患者的观点。

Patient-Defined Treatment Success: Perspectives of Patients With Advanced-Stage Lung Cancer.

机构信息

Augusta University Georgia Medical College, Augusta, GA.

University of Nebraska Medical Center College of Public Health, Omaha, NE.

出版信息

J Oncol Pract. 2019 Sep;15(9):e758-e768. doi: 10.1200/JOP.18.00734. Epub 2019 Jul 19.

Abstract

PURPOSE

In the United States, lung cancer accounts for 14% of cancer diagnoses and 28% of cancer deaths annually. Because no cure exists for advanced lung cancer, the primary treatment goal is to prolong survival.

OBJECTIVES

The study aim was to determine whether individual preferences, characteristics, and treatment experiences affect the meaning of treatment success.

MATERIALS AND METHODS

A quantitative study using an observational, longitudinal cohort of patients with advanced stage non-small-cell lung cancer was conducted. Data sources included medical records and patient interviews. Data were analyzed using χ, Fisher's exact, and McNemar's tests, as well as logistic regressions.

RESULTS

At the first interview of 235 individuals, 12% considered survival alone as their definition of treatment success; others defined treatment success as survival plus other aspects, such as quality of life and reaching an important personal goal. As they moved through chemotherapy, 47% of the patients changed their definition of treatment success. Bivariate analysis showed that patients with lower incomes tended to be more likely to change their definition of treatment success compared with their counterparts with higher income ( = .0245).

CONCLUSION

By taking chemotherapy, patients expect to increase their odds of survival and want to maintain the quality of life and functionality. A patient's definition of treatment success is often changing as treatment continues, making it appropriate to ensure patient-provider communication throughout their clinical care. The study results are limited to patients with advanced non-small-cell lung cancer and drawn from a predominantly white patient population, mainly from the US Midwest.

摘要

目的

在美国,肺癌每年占癌症诊断的 14%和癌症死亡的 28%。由于没有治愈晚期肺癌的方法,主要的治疗目标是延长生存时间。

目的

本研究旨在确定个人偏好、特征和治疗经验是否会影响治疗成功的意义。

材料和方法

采用观察性、纵向非小细胞肺癌晚期患者队列的定量研究。数据来源包括病历和患者访谈。使用 χ²、Fisher 确切检验和 McNemar 检验以及逻辑回归分析进行数据分析。

结果

在 235 名个体的第一次访谈中,12%的人将单独的生存视为治疗成功的定义;其他人将治疗成功定义为生存加上其他方面,如生活质量和实现重要的个人目标。随着他们接受化疗,47%的患者改变了他们对治疗成功的定义。单变量分析显示,与收入较高的患者相比,收入较低的患者更有可能改变他们对治疗成功的定义( =.0245)。

结论

通过接受化疗,患者希望增加生存的机会,并希望维持生活质量和功能。随着治疗的继续,患者对治疗成功的定义经常发生变化,因此在整个临床护理过程中确保医患沟通是合适的。研究结果仅限于晚期非小细胞肺癌患者,且来自以美国中西部为主的白人患者群体。

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