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患者参与多学科肿瘤会议是否与其信息需求相关?一项多中心前瞻性观察研究。

Is patient participation in multidisciplinary tumour conferences associated with their information needs? A multicentre prospective observational study.

机构信息

Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany

Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.

出版信息

BMJ Open. 2021 Sep 23;11(9):e049199. doi: 10.1136/bmjopen-2021-049199.

Abstract

OBJECTIVES

To determine the association between participation of patients with breast cancer and patients with gynaecological cancer in their own multidisciplinary tumour conference (MTC) and their information needs with regard to their disease and treatment options.

METHODS

This is a prospective observational study that took place at six breast cancer and gynaecological cancer centres in North Rhine-Westphalia, Germany. Patient inclusion criteria included a minimum age of 18 years and at least one diagnosis of breast cancer or gynaecological cancer. Three surveys were administered. T0 (shortly before MTC), T1 (directly after MTC) and T2 (4 weeks after MTC). Patient information needs were measured using two three-item subscales of the Cancer Patients Information Needs scale. Analysis of change was done by one-way repeated measures analysis of variance (ANOVA). To control for sampling bias, a further one-way repeated measures analysis of covariance (ANCOVA) included a propensity score as a covariate.

RESULTS

Data from 81 patients in the participation group and 120 patients in the non-participation group were analysed. The patient groups did not differ in their levels of information needs at T0 or T2. From T0 to T2, information needs increased statistically significantly in both groups with regard to both disease-related information (η²=0.354) and treatment-related information (η²=0.250). The increase in both types of information needs lost its statistical significance when the propensity score was included as a covariate. Neither ANOVA nor ANCOVA revealed a statistically significant association between patients' participation in the MTC and their self-reported information needs.

CONCLUSION AND CLINICAL IMPLICATIONS

As concerns patients' information needs, findings do not support a general recommendation for or against the participation of patients in their MTCs. Future research should focus on the different ways of patients' participation in their MTCs facilitated at different cancer centres. Further research should also aim to establish which patient and disease characteristics predispose patients to benefit from participating in their MTCs.

摘要

目的

确定参与多学科肿瘤会议(MTC)的乳腺癌和妇科癌症患者及其对疾病和治疗方案的信息需求与他们的参与之间的关联。

方法

这是一项在德国北莱茵-威斯特法伦州的六家乳腺癌和妇科癌症中心进行的前瞻性观察性研究。患者纳入标准包括年龄至少 18 岁,至少有一次乳腺癌或妇科癌症的诊断。进行了三项调查。T0(在 MTC 之前不久)、T1(在 MTC 之后直接)和 T2(MTC 后 4 周)。使用癌症患者信息需求量表的两个三项目子量表测量患者的信息需求。采用单向重复测量方差分析(ANOVA)进行变化分析。为了控制抽样偏差,进一步的单向重复测量协方差分析(ANCOVA)将倾向评分作为协变量。

结果

对参与组的 81 名患者和不参与组的 120 名患者的数据进行了分析。患者组在 T0 或 T2 时的信息需求水平没有差异。从 T0 到 T2,两组患者的疾病相关信息(η²=0.354)和治疗相关信息(η²=0.250)的信息需求均有统计学显著增加。当将倾向评分作为协变量纳入时,两种类型的信息需求的增加均失去统计学意义。ANOVA 和 ANCOVA 均未显示患者参与 MTC 与其自我报告的信息需求之间存在统计学显著关联。

结论和临床意义

就患者的信息需求而言,研究结果不支持普遍建议患者参与或不参与他们的 MTC。未来的研究应侧重于不同癌症中心促进的患者参与 MTC 的不同方式。进一步的研究还应旨在确定哪些患者和疾病特征使患者有资格从参与 MTC 中受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bee/8461738/bcadd1a4d85e/bmjopen-2021-049199f01.jpg

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