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日本的患者、医生和护士对乳腺癌治疗的看法存在差异,以及信息需求未得到满足。

Differences in perception of breast cancer treatment between patients, physicians, and nurses and unmet information needs in Japan.

机构信息

Division of Breast Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8555, Japan.

Division of Adult Nursing, Department of Nursing, Graduate School of Health Sciences, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8555, Japan.

出版信息

Support Care Cancer. 2020 May;28(5):2331-2338. doi: 10.1007/s00520-019-05029-z. Epub 2019 Sep 3.

Abstract

PURPOSE

Discrepancies exist between healthcare provider and patient perceptions surrounding breast cancer treatment. Significant treatment changes in the last 10 years have made re-evaluation of these perceptions necessary.

METHODS

Physicians and nurses involved in breast cancer treatment, and patients who had received breast cancer chemotherapy (past 5 years), were questioned using an Internet survey. Participants ranked physical concerns (treatment side effects), psychological concerns, priorities for treatment selection, and side effects to be avoided during treatment. Patients were asked about desired treatment information/information sources. Rankings were calculated using the mean value of scores. Spearman's rank correlation was used to determine the concordance of rankings among groups.

RESULTS

Survey respondents included 207 patients, 185 physicians, and 150 nurses. Patients and nurses similarly ranked distressing physical concerns; physician rankings differed. Quality of life (QoL) and treatment response ranked high with physicians and patients when considering future treatment; nurses prioritized QoL. All three groups generally agreed on ranking of psychological concerns experienced during chemotherapy, explanation of treatment options, and how treatment decisions were made, although more patients thought treatment decisions should be made independently. Healthcare providers reported providing explanations of treatment side effects and information on physical/psychological support options while patients felt both were lacking. Concordance was calculated as 0.47 (patient-physician), 0.83 (patient-nurse), and 0.76 (physician-nurse). Patients desired additional information, preferring healthcare providers as the source.

CONCLUSIONS

Specific areas for improvement in breast cancer patient care were identified; programs should be implemented to address unmet needs and improve treatment in these areas.

摘要

目的

在乳腺癌治疗方面,医患双方的看法存在差异。过去 10 年中治疗方式发生了重大变化,因此有必要重新评估这些看法。

方法

通过互联网调查,对参与乳腺癌治疗的医生和护士以及过去 5 年内接受过乳腺癌化疗的患者进行了询问。参与者对身体问题(治疗副作用)、心理问题、治疗选择的优先级以及治疗过程中需要避免的副作用进行了排名。患者被问及他们希望获得的治疗信息/信息来源。使用评分的平均值计算排名。采用 Spearman 秩相关来确定组间排名的一致性。

结果

调查对象包括 207 名患者、185 名医生和 150 名护士。患者和护士对令人痛苦的身体问题的排名相似;而医生的排名则不同。在考虑未来治疗时,医生和患者都认为生活质量(QoL)和治疗反应很重要;护士则更注重 QoL。三组人员对化疗期间的心理问题、治疗方案的解释以及治疗决策的制定都有相似的排名,尽管更多的患者认为治疗决策应该独立做出。医疗保健提供者报告提供了治疗副作用的解释和身体/心理支持方案的信息,但患者认为这些信息都缺乏。一致性计算结果为 0.47(患者-医生)、0.83(患者-护士)和 0.76(医生-护士)。患者希望获得更多信息,更倾向于从医疗保健提供者处获取。

结论

确定了乳腺癌患者护理中需要改进的具体领域;应实施相关计划,以满足未满足的需求,并改善这些领域的治疗效果。

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