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患者参与多学科肿瘤会议:如何实施?患者的角色是什么?患者的体验是什么?

Patient participation in multidisciplinary tumor conferences: How is it implemented? What is the patients' role? What are patients' experiences?

机构信息

Division for Organizational Health Services Research, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany.

Department for Psychosomatic Medicine and Psychotherapy, Center for Integrated Oncology (CIO Bonn), Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany.

出版信息

Cancer Med. 2021 Oct;10(19):6714-6724. doi: 10.1002/cam4.4213. Epub 2021 Aug 17.

Abstract

BACKGROUND

Prior research has shown that around 5%-7% of patients in breast cancer centers in Germany participate in the discussion of their own case within a multidisciplinary tumor conference (MTC). The PINTU study is one of the first to research this practice. The objective is to describe (a) how patient participation in MTCs is implemented, (b) what is the role of patients, and (c) how patients experience MTCs.

METHODS

MTCs in six breast and gynecological cancer centers in North Rhine-Westphalia, Germany, with and without patient participation, are studied prospectively by (non)participatory, structured observation. Breast and gynecological cancer patients completed surveys before, directly after, and 4 weeks after MTC participation. Data are analyzed descriptively.

RESULTS

Case discussions of a sample of n = 317 patients (n = 95 with MTC participation and n = 222 without) were observed. Survey data were obtained from n = 242 patients (n = 87 and n = 155). Observational data showed heterogeneity in the ways MTC participation was practiced. Among participating patients, 89% had the opportunity to express their opinion and 61% were involved in decision-making. Whereas most patients reported positive experiences and would recommend participation, some had negative experiences and regretted participating.

CONCLUSIONS

Due to a lack of recommendations, hospitals implement patient participation in MTCs in many different ways. So far, it is unknown which setting and procedures of MTC participation are beneficial for patients. However, existing evidence on communication in cancer care together with this exploratory study's findings can build the basis for developing recommendations for hospitals that invite their patients to MTCs.

CLINICAL TRIAL REGISTRATION NUMBER

German Clinical Trials Register Nr. DRKS00012552.

摘要

背景

先前的研究表明,德国乳腺癌中心约有 5%-7%的患者会参与多学科肿瘤会议(MTC)中自身病例的讨论。PINTU 研究是首批对此类实践进行研究的研究之一。该研究的目的是描述:(a)MTC 中患者参与的实施方式;(b)患者的角色;以及(c)患者对 MTC 的体验。

方法

本研究采用(非)参与性、结构性观察法,前瞻性研究了德国北莱茵-威斯特法伦州 6 家乳腺癌和妇科癌症中心的 MTC(有患者参与和无患者参与)。乳腺癌和妇科癌症患者在参与 MTC 之前、之后以及 4 周后完成了调查。数据分析采用描述性方法。

结果

观察了 n=317 例患者(n=95 例有 MTC 参与,n=222 例无)的病例讨论。n=242 例患者(n=87 例和 n=155 例)提供了调查数据。观察性数据显示 MTC 参与的实施方式存在异质性。在参与的患者中,89%有机会表达意见,61%参与决策。大多数患者报告了积极的体验并会推荐参与,但也有一些患者体验不佳并后悔参与。

结论

由于缺乏建议,医院以多种不同的方式实施 MTC 中的患者参与。迄今为止,尚不清楚哪种 MTC 参与的设置和程序对患者有益。然而,现有的癌症护理沟通证据以及本探索性研究的结果可以为邀请患者参与 MTC 的医院制定建议奠定基础。

临床试验注册号

德国临床试验注册中心编号 DRKS00012552。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3148/8495269/b7be3493f304/CAM4-10-6714-g003.jpg

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