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胶质母细胞瘤治疗中的沟通:对患者、护理人员和医疗保健专业人员最重要的因素的定性研究。

Communication in the context of glioblastoma treatment: A qualitative study of what matters most to patients, caregivers and health care professionals.

机构信息

Leeds Institute of Medical Research, St James's Hospital, University of Leeds, Leeds, UK.

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

出版信息

Palliat Med. 2023 Jun;37(6):834-843. doi: 10.1177/02692163231152525. Epub 2023 Feb 3.

Abstract

BACKGROUND

Patients with glioblastoma have a poor prognosis and treatment is palliative in nature from diagnosis. It is therefore critical that the benefits and burdens of treatments are clearly discussed with patients and caregivers.

AIM

To explore experiences and preferences around glioblastoma treatment communication in patients, family caregivers and healthcare professionals.

DESIGN

Qualitative design. A thematic analysis of semi-structured interviews.

SETTING/PARTICIPANTS: A total of 15 adult patients with glioblastoma, 13 caregivers and 5 healthcare professionals were recruited from Leeds Teaching Hospitals NHS Trust.

RESULTS

Four themes were identified: (1) . Risks and side-effects of anti-tumour treatments were explained clearly, with information layered and repeated. Treatment was often understood to be 'the only option'. Understanding the impact of side-effects could be enhanced, alongside information about support services. (2) . Patients/caregivers valued being well-supported by a trusted treatment team, feeling involved, having control and quality of life. Healthcare professionals similarly highlighted trust, maintaining independence and emotional support as key. (3) . With limited treatment options, trust and control are crucial in decision-making. Patients ultimately prefer to follow healthcare professional advice but want to be involved, consider alternatives and voice what matters to them. (4) . During the pandemic, greater efforts to maintain good communication were necessary. Negative impacts of COVID-19 were limited, caregivers appeared most disadvantaged by pandemic-related restrictions.

CONCLUSIONS

In glioblastoma treatment communication, where prognosis is poor and treatmentwill not result in cure, building trusting relationships, maintaining a sense of control and being well-informed are identified as critical.

摘要

背景

胶质母细胞瘤患者预后较差,从诊断开始治疗就具有姑息性质。因此,与患者和照护者清楚地讨论治疗的益处和负担至关重要。

目的

探讨患者、家属照护者和医疗保健专业人员在胶质母细胞瘤治疗沟通方面的经验和偏好。

设计

定性设计。对半结构化访谈进行主题分析。

地点/参与者:共招募了来自利兹教学医院 NHS 信托基金会的 15 名胶质母细胞瘤成年患者、13 名家属照护者和 5 名医疗保健专业人员。

结果

确定了四个主题:(1). 抗肿瘤治疗的风险和副作用解释得很清楚,信息分层并重复。治疗通常被认为是“唯一的选择”。可以更好地理解副作用的影响,同时了解支持服务的信息。(2). 患者/照护者非常依赖值得信赖的治疗团队,感到被重视、有掌控权和有生活质量。医疗保健专业人员同样强调信任、保持独立性和情感支持是关键。(3). 在治疗选择有限的情况下,信任和控制在决策中至关重要。患者最终更愿意听从医疗保健专业人员的建议,但希望参与其中,考虑替代方案,并表达对他们重要的事情。(4). 在大流行期间,需要更加努力地保持良好的沟通。COVID-19 的负面影响有限,但疫情相关限制对家属照护者的影响最大。

结论

在预后较差且治疗不会治愈的胶质母细胞瘤治疗沟通中,建立信任关系、保持控制感和充分知情被确定为关键。

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