外科医生在乳腺癌手术咨询中缓解情绪的作用：一项关于患者在 Alliance A231701CD 中的体验的定性研究。
Role of the Surgeon in De-Escalating Emotion During a Breast Cancer Surgery Consultation: A Qualitative Study of Patients' Experiences in Alliance A231701CD.
机构信息
Wisconsin Surgical Outcomes Research Program, University of Wisconsin, Madison, WI, USA.
University of Wisconsin Institute for Clinical and Translational Research, Madison, WI, USA.
出版信息
Ann Surg Oncol. 2024 Dec;31(13):8873-8881. doi: 10.1245/s10434-024-16156-1. Epub 2024 Sep 25.
BACKGROUND
Patient engagement in decision making can improve satisfaction with care. Studies demonstrate that patients' emotional states can be significant barriers to engaging in shared decision making.
OBJECTIVE
We sought to examine how emotion associated with a breast cancer diagnosis impacts patient experiences during the surgical consultation, and explore opportunities for surgeons to mitigate the impact of emotion.
METHODS
We conducted 30 semi-structured interviews with patients who participated in the decision aid arm of Alliance A231701CD, had low engagement, and experienced barriers to engagement. We used qualitative content analysis to analyze the interview data and organize it into overarching themes.
RESULTS
Participants recalled strong emotions with their diagnosis, describing it as devastating and shocking. Although several participants said that their emotional reaction to the diagnosis lessened over time, others expressed still feeling very anxious. Participants described ways in which their surgeon helped to de-escalate their emotional state, beginning with the establishment of rapport and continuing through treatment planning. Participants valued surgeons who they perceived to be personable and compassionate, treated them as an individual, provided reassuring and matter-of-fact information about their cancer, and efficiently communicated plans for next steps.
CONCLUSIONS
Patients with breast cancer are often emotionally overwhelmed during their surgical consults, which impedes their ability to listen and participate in decision making. However, surgeon behaviors can help de-escalate emotions. Addressing emotion is critical to support patients in reaching a decision for breast cancer surgery and is likely to improve patient satisfaction with the decision process.
CLINICAL TRIALS REGISTRATION
ClinicalTrials.gov identifier: NCT03766009.
背景
患者参与决策可以提高对护理的满意度。研究表明，患者的情绪状态可能是参与共同决策的重大障碍。
目的
我们旨在研究与乳腺癌诊断相关的情绪如何影响患者在手术咨询期间的体验，并探讨外科医生减轻情绪影响的机会。
方法
我们对参与 Alliance A231701CD 决策辅助臂、参与度低且面临参与障碍的 30 名患者进行了半结构化访谈。我们使用定性内容分析方法对访谈数据进行分析，并将其组织成总体主题。
结果
参与者回忆起与诊断相关的强烈情绪，称其为毁灭性和令人震惊的。尽管一些参与者表示随着时间的推移，他们对诊断的情绪反应减轻了，但其他人仍表示感到非常焦虑。参与者描述了他们的外科医生帮助缓解情绪状态的方式，从建立融洽关系开始，一直持续到治疗计划。参与者重视他们认为有人情味和同情心的外科医生，将他们视为个体，提供关于癌症的安心和实事求是的信息，并有效地沟通下一步计划。
结论
乳腺癌患者在手术咨询期间常常情绪激动，这阻碍了他们倾听和参与决策的能力。然而，外科医生的行为可以帮助缓解情绪。解决情绪问题对于支持患者做出乳腺癌手术决策至关重要，并且可能会提高患者对决策过程的满意度。
临床试验注册
ClinicalTrials.gov 标识符：NCT03766009。
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