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治疗信心与患者在多学科肿瘤会议中的参与:结构方程建模方法。

Treatment confidence and patient participation in multidisciplinary tumor conferences: A structural equation modeling approach.

机构信息

Department for Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Center for Health Communication and Health Services Research, University Hospital Bonn, Bonn, Germany.

Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany.

出版信息

Cancer Med. 2024 May;13(10):e7199. doi: 10.1002/cam4.7199.

Abstract

OBJECTIVE

Multidisciplinary tumor conference (MTC) is a key instrument in multidisciplinary cancer care. In recent years, if and how patient participation in MTC can contribute to a more patient-centered care have been scientifically discussed. This study aimed to identify determinants of treatment confidence in the context of patient participation in MTC. Therefore, the association among health literacy-sensitive communication, trust in health-care providers (HCP), and treatment confidence is examined.

METHODS

This study used data from the multicenter, observational study "PINTU" on patient participation in MTC. Data were collected from November 2018 to February 2020. Validated scales for treatment confidence, health literacy-sensitive communication, and trust in providers were included in the structural equation modeling (SEM) analysis.

RESULTS

A total of 95 patients participated in MTC. The sample compromised n = 80 completed datasets. The SEM fit measures indicated good fit of the proposed model. The analysis showed a positive association between health literacy-sensitive communication and treatment confidence when adding the mediating effect of trust in providers.

CONCLUSION

Patient-centered communication during MTC in combination with a trustful relationship between participating patients and health-care providers is positively associated with treatment confidence. The results indicated the relevance of a trustful doctor-patient communication and relationship. Trainings for physicians targeting patient-centered communication could be a promising approach to strengthen patient participation.

摘要

目的

多学科肿瘤会议(MTC)是多学科癌症治疗的重要手段。近年来,患者参与 MTC 是否以及如何有助于实现更加以患者为中心的护理已得到科学探讨。本研究旨在确定患者参与 MTC 背景下治疗信心的决定因素。因此,考察了健康素养敏感型沟通、对医疗保健提供者的信任与治疗信心之间的关系。

方法

本研究使用了多中心、观察性研究“PINTU”中关于患者参与 MTC 的数据。数据收集于 2018 年 11 月至 2020 年 2 月。结构方程模型(SEM)分析中纳入了治疗信心、健康素养敏感型沟通和对提供者信任的经过验证的量表。

结果

共有 95 名患者参加了 MTC。样本由 80 名完成数据集的患者组成。SEM 拟合度指标表明,所提出模型的拟合度良好。分析表明,当加入对提供者的信任的中介效应时,健康素养敏感型沟通与治疗信心之间呈正相关。

结论

MTC 期间以患者为中心的沟通,结合参与患者与医疗保健提供者之间的信任关系,与治疗信心呈正相关。结果表明了信任的医患沟通和关系的重要性。针对以患者为中心的沟通对医生进行培训可能是增强患者参与的一种有前途的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/948a/11129163/5e92a4b18528/CAM4-13-e7199-g001.jpg

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本文引用的文献

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