Department of Family Medicine, University of Washington, School of Medicine, Box 356390, Seattle, WA, 98195, USA.
LUNGevity Foundation, Chicago, IL, USA.
Support Care Cancer. 2022 Nov;30(11):9049-9055. doi: 10.1007/s00520-022-07309-7. Epub 2022 Aug 11.
To support the care of lung cancer patients, oncologists have needed to stay current on treatment advancements and build relationships with a new group of survivors in an era where lung cancer survivorship has been re-defined. The objectives of the study were to (1) understand the perspectives of advanced lung cancer patients whose tumors have oncogenic alterations about their care experiences with their oncologist(s) and (2) describe the perceptions of advanced lung cancer patients about seeking second opinions and navigating care decisions.
In this qualitative study, patients with advanced lung cancer (n = 25) on targeted therapies were interviewed to discuss their ongoing experience with their oncologists. We used deductive and inductive qualitative approaches in the coding of the data. We organized the data using the self-determination framework.
Patients described both positive and negative aspects of their care as related to autonomy, provider competency, and connectedness. Patients sought second opinions for three primary reasons: expertise, authoritative advice, and access to clinical trial opportunities. When there is disagreement in the treatment plan between the primary oncologist and the specialist, there can be confusion and tension, and patients have to make difficult choices about their path forward.
Patients value interactions that support their autonomy, demonstrate the competency of their providers, and foster connectedness. To ensure that patients receive quality and goal-concordant care, developing decision aids and education materials that help patients negotiate recommendations from two providers is an area that deserves further attention.
为了支持肺癌患者的护理，肿瘤学家需要紧跟治疗进展，并在肺癌生存者被重新定义的时代与新的生存者群体建立关系。本研究的目的是：（1）了解肿瘤携带致癌突变的晚期肺癌患者对其与肿瘤医生护理体验的看法；（2）描述晚期肺癌患者对寻求第二意见和决策护理的看法。
在这项定性研究中，对正在接受靶向治疗的晚期肺癌患者（n=25）进行了访谈，以讨论他们与肿瘤医生持续的治疗体验。我们在数据编码中使用了演绎和归纳的定性方法。我们使用自主决定框架来组织数据。
患者描述了他们的护理中与自主性、提供者能力和联系相关的积极和消极方面。患者寻求第二意见有三个主要原因：专业知识、权威建议和获得临床试验机会。当主要肿瘤医生和专家的治疗方案存在分歧时，可能会出现困惑和紧张，患者必须在自己的前进道路上做出艰难的选择。
患者重视支持他们自主性、展示提供者能力和促进联系的互动。为了确保患者获得高质量和目标一致的护理，开发帮助患者协商两位提供者建议的决策辅助工具和教育材料是一个值得进一步关注的领域。
