Comprehensive Cancer Center Munich, partner site TUM, Klinikum rechts der Isar, Munich, Germany.
Comprehensive Cancer Center Munich, partner site LMU, University hospital, LMU Munich, Munich, Germany.
Support Care Cancer. 2021 Apr;29(4):2171-2178. doi: 10.1007/s00520-020-05692-7. Epub 2020 Sep 3.
Despite promising achievements in precision cancer medicine (PCM), participating patients are still faced with manifold uncertainties, especially regarding a potential treatment benefit of molecular diagnostics (MD). Hence, MD poses considerable challenges for patient information and communication. To meet these challenges, healthcare professionals need to gain deeper insight into patients' subjective experiences. Therefore, this qualitative study examined information aspects of MD programs in cancer patients.
In two German Comprehensive Cancer Centers, 30 cancer patients undergoing MD participated in semi-structured interviews on information transfer and information needs regarding MD. Additionally, patients provided sociodemographic and medical data and indicated their subjective level of information (visual analogue scale, VAS, 0-10).
On average patients had high levels of information (mean = 7, median = 8); nevertheless 20% (n = 6) showed an information level below 5 points. Qualitative analysis revealed that patients show limited understanding of the complex background of MD and have uncertainties regarding their personal benefit. Further, patients described unmet information needs. Existential threat in awaiting the results was experienced as burdensome. To withstand the strains of their situation, patients emphasized the importance of trusting their physician.
The challenges in PCM consist in providing unambiguous information, especially concerning treatment benefit, and providing guidance and support. Therefore, psycho-oncology needs to develop guidelines for adequate patient communication in order to help healthcare providers and cancer patients to handle these challenges in the developing field of PCM.
尽管精准癌症医学（PCM）取得了有希望的成就，但参与的患者仍然面临着多种不确定性，尤其是关于分子诊断（MD）的潜在治疗益处。因此，MD 对患者信息和沟通提出了相当大的挑战。为了应对这些挑战，医疗保健专业人员需要更深入地了解患者的主观体验。因此，本定性研究考察了癌症患者 MD 计划的信息方面。
在两个德国综合癌症中心，30 名接受 MD 的癌症患者参加了关于 MD 信息传递和信息需求的半结构化访谈。此外，患者提供了社会人口统计学和医疗数据，并表示了他们对 MD 的主观信息水平（视觉模拟量表，VAS，0-10）。
平均而言，患者的信息水平较高（均值=7，中位数=8）；然而，20%（n=6）的患者信息水平低于 5 分。定性分析表明，患者对 MD 复杂背景的理解有限，对自身受益存在不确定性。此外，患者描述了未满足的信息需求。等待结果带来的生存威胁被认为是负担。为了承受这种情况的压力，患者强调了信任医生的重要性。
PCM 的挑战在于提供明确的信息，特别是关于治疗益处，并提供指导和支持。因此，肿瘤心理学需要制定适当的患者沟通指南，以帮助医疗保健提供者和癌症患者应对 PCM 这一发展领域中的这些挑战。
