Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan; Karmanos Cancer Center, Detroit, Michigan.
Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan.
Int J Radiat Oncol Biol Phys. 2023 Jan 1;115(1):233-243. doi: 10.1016/j.ijrobp.2022.10.011. Epub 2022 Oct 13.
The complex technological processes involved in radiation therapy can be intimidating to patients, causing increased treatment-related anxiety and reduced satisfaction. An intervention was implemented to provide direct consultations between patients and medical physicists to reduce patient anxiety and improve patient satisfaction. A randomized clinical trial was conducted to test the intervention's effect on anxiety, distress, treatment adherence, technical understanding, and satisfaction in patients receiving radiation therapy.
Eligible patients were recruited into "intervention" and "standard of care" arms within a phase 2 screening randomized trial. Intervention-arm patients met with a medical physicist who provided technical information and addressed patient questions or concerns at the time of treatment simulation and before the first treatment. In addition to baseline information collected before randomization, participants were surveyed (1) before simulation, (2) before the first treatment, and (3) before the completion of treatment to evaluate the study endpoints. Primary endpoints included patient anxiety and distress. Secondary endpoints included patient treatment adherence, overall satisfaction, and technical understanding of treatment. Patients in the intervention arm were surveyed before and after each physicist meeting.
Participant anxiety was significantly reduced in the intervention arm (difference, -0.29; 95% confidence interval, -0.57 to -0.02; P = .038). No differences in distress or treatment adherence were observed between groups. Although measures of technical understanding and satisfaction were evaluated as exploratory objectives, participants in the intervention group were more likely to feel that technical aspects of treatment were adequately explained (difference, 0.78; 95% confidence interval, 0.03-1.54), and all measures of technical understanding and satisfaction were considerably higher in the intervention group at the time of the first visit.
The establishment of a direct patient-provider relationship with the medical physicist reduced anxiety in patients receiving radiation therapy. In addition, increases in patient understanding of the technical aspects of care and in satisfaction were observed at the initiation of treatment.
放射治疗涉及复杂的技术过程，这可能会令患者感到恐惧，增加与治疗相关的焦虑感并降低满意度。我们实施了一项干预措施，为患者提供与医学物理学家的直接咨询，以降低患者的焦虑感并提高其满意度。我们进行了一项随机临床试验，以检验该干预措施对接受放射治疗患者的焦虑、痛苦、治疗依从性、对技术的理解和满意度的影响。
在一项 2 期筛选随机试验中，将符合条件的患者招募至“干预”和“标准护理”组。干预组的患者与医学物理学家会面，后者在治疗模拟和第一次治疗前提供技术信息并解答患者的问题或疑虑。除随机分组前收集的基线信息外，参与者还在以下时间点接受了调查：（1）模拟前、（2）第一次治疗前、（3）治疗结束前，以评估研究终点。主要终点包括患者的焦虑和痛苦。次要终点包括患者的治疗依从性、总体满意度和对治疗的技术理解。干预组的患者在每次与物理学家会面前后均接受了调查。
干预组患者的焦虑明显降低（差异，-0.29；95%置信区间，-0.57 至 -0.02；P=0.038）。两组间的痛苦或治疗依从性无差异。尽管对技术理解和满意度的评估是作为探索性目标进行的，但干预组的参与者更有可能认为治疗的技术方面得到了充分解释（差异，0.78；95%置信区间，0.03-1.54），并且干预组在第一次就诊时所有技术理解和满意度的测量值均明显更高。
与医学物理学家建立直接的医患关系可降低接受放射治疗患者的焦虑感。此外，在开始治疗时，患者对护理技术方面的理解和满意度都有所提高。
