Hamaker Marije Emilie, van Walree Inez Charlotte, Seghers Petronella A L Nelleke, van den Bos Frederiek, Soubeyran Pierre, O'Hanlon Shane, Rostoft Siri
Department of Geriatric Medicine, Diakonessenhuis, Utrecht, the Netherlands.
Department of Geriatric Medicine, Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands.
J Geriatr Oncol. 2022 Apr;13(3):265-272. doi: 10.1016/j.jgo.2021.09.011. Epub 2021 Sep 24.
Understanding what information patients want and need is an important step in optimizing care. Therefore, we set out to collect all available evidence about the information that is most important to older patients with a new cancer diagnosis and whether or not these information needs are sufficiently addressed.
A systematic literature review of Embase and Medline.
We included eighteen studies addressing the importance of a range of information topics and studies addressing the sufficiency of information provided. On a scale from 1 to 10, patients ranked information about prognosis and the chance of cure as the most important category (median ranking 10, interquartile range (IQR) 8-10), followed by information on cancer itself (median 9, IQR 5.5-9), and treatment options (median 8, IQR 8-9). Information on side-effects of treatment (median 7, IQR 6-8), and practicalities (median 6, IQR 5-7.5) were also considered important. Patients rated information about the practicalities of treatment as the most insufficiently addressed (median 9.5), followed by self-care at home (median 9), and information about prognosis and side-effects (median 8 for both).
This systematic review demonstrates that information provision about the cancer itself and about treatment options is generally satisfactory to patients, while information about prognosis, practicalities of treatment and self-care at home could be improved. However, there is significant heterogeneity among older patients regarding which information is most important to them, thus requiring an ongoing dialogue between patients and health care providers about which information is most needed at any given time.
了解患者想要和需要的信息是优化医疗护理的重要一步。因此,我们着手收集所有现有证据,以了解对于新确诊癌症的老年患者而言最重要的信息,以及这些信息需求是否得到了充分满足。
对Embase和Medline进行系统的文献综述。
我们纳入了18项涉及一系列信息主题重要性的研究,以及涉及所提供信息充分性的研究。在1至10的评分量表上,患者将关于预后和治愈机会的信息列为最重要的类别(中位数排名10,四分位间距(IQR)8 - 10),其次是关于癌症本身的信息(中位数9,IQR 5.5 - 9),以及治疗选择(中位数8,IQR 8 - 9)。关于治疗副作用的信息(中位数7,IQR 6 - 8)和实际问题(中位数6,IQR 5 - 7.5)也被认为很重要。患者认为关于治疗实际问题的信息是最未得到充分满足的(中位数9.5),其次是在家自我护理(中位数9),以及关于预后和副作用的信息(两者中位数均为8)。
这项系统综述表明,关于癌症本身和治疗选择的信息提供总体上令患者满意,而关于预后、治疗实际问题和在家自我护理的信息可以改进。然而,老年患者对于哪些信息对他们最重要存在显著的异质性,因此需要患者与医疗保健提供者就任何特定时间最需要的信息进行持续对话。