University of Texas Southwestern Medical Center, Dallas, TX.
Purdue University, West Lafayette, IN.
JCO Oncol Pract. 2020 Jan;16(1):e64-e74. doi: 10.1200/JOP.19.00315. Epub 2019 Oct 7.
Effective enrollment and treatment of patients in cancer clinical trials require definition and coordination of roles and responsibilities among clinic and research personnel.
We developed a survey that incorporated modified components of the Survey of Physician Attitudes Regarding the Care of Cancer Survivors. Surveys were administered to clinic nursing staff and research personnel at a National Cancer Institute-designated comprehensive cancer center. Results were analyzed using χ-tests, tests, and analyses of variance.
Surveys were completed by 105 staff members (n = 50 research staff, n = 55 clinic staff; 61% response rate). Research staff were more likely to feel that they had the skills to answer questions, convey information, and provide education for patients on trials (all < .05). Both clinic and research staff reported receipt of communication about responsibilities in fewer than 30% of cases, although research staff reported provision of such information in more than 60% of cases. Among 20 tasks related to care of patients in trials, no single preferred model of responsibility assignment was selected by the majority of clinic staff for nine tasks (45%) or by research staff for three tasks (15%). Uncertainty about which team coordinates care was reported by three times as many clinic staff as research staff ( = .01). There was also substantial variation in the preferred model for delivery of care to patients in trials ( < .05).
Knowledge, attitudes, and perception of care and responsibilities for patients on clinical trials differ between and among clinic and research personnel. Additional research about how these findings affect efficiency and quality of care on clinical trials is needed.
为了有效招募癌症临床试验患者并为其提供治疗，需要明确并协调临床和研究人员的角色和职责。
我们开发了一份调查问卷，其中纳入了《医师对癌症幸存者护理态度调查》的修改内容。该调查问卷在一家美国国立癌症研究所指定的综合性癌症中心向临床护理人员和研究人员发放。采用卡方检验、t 检验和方差分析对结果进行分析。
共 105 名工作人员（研究人员 50 名，临床工作人员 55 名；应答率为 61%）完成了调查问卷。研究人员更有可能认为自己具备回答问题、传递信息和为患者提供临床试验教育的技能（均 P <.05）。虽然研究人员报告称在超过 60%的情况下提供了此类信息，但临床和研究人员报告称，在不到 30%的情况下收到了关于职责的沟通。在与患者参与临床试验相关的 20 项任务中，没有一项任务得到了大多数临床工作人员（45%）或研究工作人员（15%）的多数支持。三分之二的临床工作人员报告不确定由哪个团队协调患者的护理工作，而研究人员报告的比例为 1/3（P =.01）。此外，为参与临床试验的患者提供护理的首选模式也存在很大差异（P <.05）。
临床和研究人员在临床试验患者的护理知识、态度和责任认知方面存在差异。需要进一步研究这些发现如何影响临床试验的护理效率和质量。
