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卵巢癌患者感知的以患者为中心的沟通、生活质量和症状负担。

Perceived patient-centered communication, quality of life, and symptom burden in individuals with ovarian cancer.

机构信息

Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States.

Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States.

出版信息

Gynecol Oncol. 2021 Nov;163(2):408-418. doi: 10.1016/j.ygyno.2021.08.007. Epub 2021 Aug 26.

Abstract

OBJECTIVE

To describe perceptions of patient-centered communication (PCC); assess whether physician specialty, patient characteristics, or health system characteristics are associated with PCC; and identify associations between PCC, health-related quality of life (HRQoL), and symptom burden among individuals with ovarian cancer.

METHODS

Cross-sectional, descriptive survey of English-speaking adults with ovarian cancer. PCC, HRQoL, and ovarian cancer symptom burden were assessed with the PCC-Ca-36, the FACT-G, and the FOSI-18, respectively. PCC-Ca-36 scores were summarized using descriptive statistics. Predictors of PCC-Ca-36, FACT-G, and FOSI-18 scores were identified using multiple linear regression.

RESULTS

Participants (n = 176) had a mean age of 59.4 years (SD = 12.1). The majority (65.9%) had advanced-stage disease, while 42.0% were receiving treatment. The mean PCC-Ca-36 total score was 4.09 (SD = 0.78) out of a possible 5, indicating participants often perceived that clinicians engaged in PCC. Among the PCC functions, participants reported that clinicians least often enabled patient self-management (M = 3.65, SD = 0.99), responded to emotions (M = 3.84, SD = 1.04), and managed uncertainty (M = 3.91, SD = 0.93). In multivariable analyses, neither physician specialty nor patient and health system characteristics were significantly associated with overall PCC. Greater overall PCC predicted better overall HRQoL; better social/family, emotional, and functional well-being; and lower overall and physical symptom burden (all p ≤ 0.05).

CONCLUSION

Greater PCC is significantly associated with better HRQoL and lower symptom burden among individuals with ovarian cancer.

PRACTICE IMPLICATIONS

Promotion of PCC is a promising strategy to improve patient-reported outcomes in the ovarian cancer care setting.

摘要

目的

描述以患者为中心的沟通(PCC)的认知;评估医师专业、患者特征或医疗体系特征是否与 PCC 相关;并确定卵巢癌患者的 PCC、健康相关生活质量(HRQoL)和症状负担之间的关联。

方法

采用横断面描述性调查方法,对英语为母语的卵巢癌成年患者进行研究。使用 PCC-Ca-36、FACT-G 和 FOSI-18 分别评估 PCC、HRQoL 和卵巢癌症状负担。使用描述性统计汇总 PCC-Ca-36 评分。使用多元线性回归确定 PCC-Ca-36、FACT-G 和 FOSI-18 评分的预测因素。

结果

参与者(n=176)的平均年龄为 59.4 岁(SD=12.1)。大多数(65.9%)患者为晚期疾病,而 42.0%的患者正在接受治疗。PCC-Ca-36 总分为 5 分中的 4.09(SD=0.78),表明患者通常认为医生在进行 PCC。在 PCC 功能中,患者报告说医生最不常帮助患者自我管理(M=3.65,SD=0.99),回应患者情绪(M=3.84,SD=1.04)和管理不确定性(M=3.91,SD=0.93)。在多变量分析中,医生专业或患者和医疗体系特征与总体 PCC 均无显著相关性。更高的总体 PCC 预测了更好的总体 HRQoL;更好的社会/家庭、情感和功能健康;以及更低的总体和身体症状负担(所有 p≤0.05)。

结论

在卵巢癌患者中,更高的 PCC 与更好的 HRQoL 和更低的症状负担显著相关。

实践意义

促进 PCC 是改善卵巢癌护理环境中患者报告结果的有前途的策略。

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