Bartley Nicci, Best Megan C, Biesecker Barbara B, Fisher Alana, Goldstein David, Meiser Bettina, Thomas David M, Ballinger Mandy L, Butow Phyllis
School of Psychology, The University of Sydney, Sydney, Australia.
School of Psychology, The University of Sydney, Sydney, Australia; Institute of Ethics and Society, The University of Notre Dame, Sydney, Australia.
Patient Educ Couns. 2022 Feb;105(2):452-459. doi: 10.1016/j.pec.2021.05.018. Epub 2021 May 14.
To understand advanced cancer patients' experience of uncertainty when receiving comprehensive tumor genomic profiling (CTGP) results, and their perceptions of how healthcare provider (HCP) communication impacts uncertainty.
Thirty-seven semi-structured interviews with advanced cancer patients were conducted within two weeks of patients receiving CTGP results. Transcripts were thematically analyzed, using an inductive approach.
We identified three themes that illustrate patient experience of uncertainties when receiving CTGP results: 1. Type and degree of uncertainty fluctuates along with changing illness circumstances and the nature of the CTGP results; 2. HCPs' co-ordination of care and communication shapes uncertainty, with immediate, clearer and simpler information promoting certainty; and 3. Patients felt that communicating results to reduce relatives' uncertainty is important, with patients choosing the time and process for achieving this and desiring HCPs support.
Oncology patients are confronted with an array of uncertainties. Clear, simple communication from HCPs about results and their implications, and support to manage uncertainty, will be of benefit.
If CTGP is to become routine clinical practice, clear communication will be crucial in reducing uncertainty. Awareness of potential uncertainties experienced by patients when receiving results, will assist HCPs to address uncertainties, reduce uncertainty where possible, and offer targeted support to patients struggling with uncertainty.
了解晚期癌症患者在收到综合肿瘤基因组分析（CTGP）结果时对不确定性的体验，以及他们对医疗服务提供者（HCP）沟通如何影响不确定性的看法。
在患者收到CTGP结果后的两周内，对37名晚期癌症患者进行了半结构化访谈。采用归纳法对访谈记录进行了主题分析。
我们确定了三个主题，阐述了患者在收到CTGP结果时对不确定性的体验：1. 不确定性的类型和程度随着病情变化以及CTGP结果的性质而波动；2. HCP的护理协调和沟通塑造了不确定性，即时、更清晰和更简单的信息可增强确定性；3. 患者认为向亲属传达结果以减少他们的不确定性很重要，患者会选择传达的时间和方式，并希望得到HCP的支持。
肿瘤患者面临一系列不确定性。HCP就结果及其影响进行清晰、简单的沟通，并提供管理不确定性的支持，将有所助益。
如果CTGP要成为常规临床实践，清晰的沟通对于减少不确定性至关重要。了解患者在收到结果时可能经历的潜在不确定性，将有助于HCP解决不确定性，尽可能降低不确定性，并为在不确定性中挣扎的患者提供有针对性的支持。
