Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany; Center for Integrated Oncology Bonn (CIO), Bonn, Germany.
Department of Urology, University Hospital Cologne, Cologne, Germany.
Patient Educ Couns. 2019 Nov;102(11):2114-2121. doi: 10.1016/j.pec.2019.07.030. Epub 2019 Aug 2.
The aim of this study is to examine associations between prostate-specific health-related quality of life (HRQOL) and aspects of patient-physician communication in localized prostate cancer treatment.
Data of patients with localized prostate cancer were collected at 6-month intervals over a 3.5-year period within a prospective, observational study (HAROW). Data collection comprised D'Amico risk categories, the Charlson Comorbidity Index, patient-physician communication (information, shared decision making, support, devotion), and prostate-specific HRQOL (incontinence aid, urinary symptoms, bowel symptoms, hormonal treatment-related symptoms, sexual functioning, sexual activity). Data of N = 1722 patients undergoing radical prostatectomy were analyzed by longitudinal multilevel analysis.
The mean patient age was 65 years; 31% had a low risk and 38% an intermediate risk of cancer growth and spread; 73% had a Charlson Comorbidity Index of 0. Significant associations were found between prostate-specific HRQOL and shared decision making, support and devotion. Patient information was not significantly associated with aspects of prostate-specific HRQOL.
Patient reported long term outcomes are associated with aspects of patient-physician communication in prostate cancer patients. Patients feeling involved by their urologists experience less side effects of (surgical) treatment.
Special communication training programmes should be developed and implemented for urologists.
本研究旨在探讨前列腺癌患者特定于前列腺的健康相关生活质量（HRQOL）与局部前列腺癌治疗中医患沟通方面之间的关联。
在一项前瞻性观察研究（HAROW）中，在 3.5 年的时间内，以 6 个月为间隔收集了局部前列腺癌患者的数据。数据收集包括 D'Amico 风险类别、Charlson 合并症指数、医患沟通（信息、共同决策制定、支持、奉献）以及前列腺特异性 HRQOL（尿失禁辅助、尿症状、肠症状、激素治疗相关症状、性功能、性行为）。通过纵向多层分析，对 1722 例接受根治性前列腺切除术的患者的数据进行了分析。
患者的平均年龄为 65 岁；31%的患者癌症生长和扩散的风险较低，38%的患者风险中等；73%的患者 Charlson 合并症指数为 0。前列腺特异性 HRQOL 与共同决策制定、支持和奉献方面显著相关。患者信息与前列腺特异性 HRQOL 方面无显著相关性。
患者报告的长期结果与前列腺癌患者医患沟通的各个方面相关。患者感到自己的泌尿科医生参与其中，会经历更少的（手术）治疗副作用。
应为泌尿科医生制定和实施专门的沟通培训计划。
