Vollmer Dahlke Deborah, Yoshikawa Aya, McAdam Molly, Malatok Sharyn, Gonzales Elaine D
Texas A&M Center for Population Health and Aging, Texas A&M University, Austin, TX, United States.
Texas Woman's University, School of Health Promotion and Kinesiology, College of Health Sciences, Denton, TX, United States.
JMIR Cancer. 2022 Mar 18;8(1):e31118. doi: 10.2196/31118.
Prior studies indicate that the age of onset of breast cancer is an important element in considering communication between patients and the health care team. Younger women aged 45 and under diagnosed with breast cancer are often at a higher risk of being more vulnerable to psychosocial issues compared to older women aged 46 years and above. Few studies have examined age differences in patient perceptions of treatment-related discussion and communication during transition with their health care team.
The aims of this survey were (1) to better understand breast cancer survivors' perspectives regarding communication with health care providers during treatment and during transition to posttreatment care; and (2) to determine the differences between younger women with breast cancer (≤45 years of age) and older women (≥46 years of age). It was hypothesized that (1) breast cancer survivors' psychosocial and finance-related communications with health care providers may lack effectiveness; (2) younger women experience greater needs for patient-centered communication with physicians and health care providers, especially about psychosocial care and transition to posttreatment care; and (3) younger breast cancer patients (≤45 years of age) need more information on survivorship and follow-up care.
An internet-based survey was conducted with 143 women in Central Texas with 35% (n=50) aged 45 years or under and 65% (n=93) aged 46 years and above. The Mann-Whitney U test was performed to assess differences in participants' perceptions about communication with health care providers by age group: younger (≤45 years of age) and older (≥46 years of age) women.
Statistically significant results pertained to rating health care team and patient discussions about transition from treatment to posttreatment using scores of 0 as "no discussion" and 100 as "in-depth discussion." For the questions about management of posttreatment care, the overall mean score of the groups was 56.26 and that of the younger group was 43.96; the mean score of the older group was 61.96 (P=.02). For the question about the timing of follow-up appointments, the overall mean score was 64.29; the mean score of the younger group was 54.44, and that of the older group was 68.88 (P=.05). All the group scores related to psychosocial and financial support discussions with health care providers were low, with a rollup average of only 30.02 out of 100, suggesting that this is an important area for improving patient-centered communication.
For all patients, transition from treatment to posttreatment requires a greater level of engagement and communication with the health care team. It appears that younger patients aged ≤45 years require more in-depth and personalized messaging to better understand their posttreatment care requirements.
先前的研究表明，乳腺癌的发病年龄是考量患者与医疗团队沟通情况的一个重要因素。与46岁及以上的老年女性相比，45岁及以下被诊断为乳腺癌的年轻女性往往更容易受到心理社会问题的影响，风险更高。很少有研究探讨患者在与医疗团队过渡期间对治疗相关讨论和沟通的年龄差异。
本次调查的目的是（1）更好地了解乳腺癌幸存者在治疗期间以及过渡到治疗后护理期间与医疗服务提供者沟通的看法；（2）确定年轻乳腺癌女性（≤45岁）和老年女性（≥46岁）之间的差异。研究假设为：（1）乳腺癌幸存者与医疗服务提供者在心理社会和财务方面的沟通可能缺乏有效性；（2）年轻女性对以患者为中心的与医生和医疗服务提供者的沟通有更大需求，尤其是关于心理社会护理和过渡到治疗后护理方面；（3）年轻乳腺癌患者（≤45岁）需要更多关于生存和后续护理的信息。
对德克萨斯州中部的143名女性进行了一项基于互联网的调查，其中35%（n = 50）年龄在45岁及以下，65%（n = 93）年龄在46岁及以上。采用曼-惠特尼U检验来评估按年龄组划分的参与者对与医疗服务提供者沟通的看法差异：年轻（≤45岁）和老年（≥46岁）女性。
在对医疗团队和患者关于从治疗过渡到治疗后护理的讨论进行评分时，得出了具有统计学意义的结果，评分为0表示“没有讨论”，100表示“深入讨论”。对于关于治疗后护理管理的问题，两组的总体平均分为56.26，年轻组为43.96；老年组的平均分为61.96（P = 0.02）。对于关于后续预约时间的问题，总体平均分为64.29；年轻组的平均分为54.44，老年组为68.88（P = 0.05）。所有与医疗服务提供者进行心理社会和财务支持讨论相关的组得分都很低，在满分100分中汇总平均仅为30.02，这表明这是改善以患者为中心的沟通的一个重要领域。
对于所有患者来说，从治疗过渡到治疗后护理需要与医疗团队有更高程度的参与和沟通。似乎45岁及以下的年轻患者需要更深入和个性化的信息，以便更好地了解他们的治疗后护理需求。
