Batten Jason N, Kennedy Kristin M, Wong Bonnie O, Kraft Stephanie A, Hanks William, Magnus David, Schapira Lidia
Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, CA 90095, United States.
Stanford University School of Medicine, Stanford, CA 94305, United States.
Oncologist. 2025 Mar 10;30(3). doi: 10.1093/oncolo/oyae296.
Treatment-oriented language is used by physicians to convey to patients that treatment is available for their cancer (eg, "our usual treatment for this is…," "we can treat this," "your cancer is still treatable"). For patients who have incurable cancer, especially for patients with a poor prognosis or who are at the end of life, it is important to understand how physicians conceptualize and use this "everyday" clinical language. We conducted a qualitative interview study with a multidisciplinary group of physicians (n = 30) who may care for patients with cancer at different points in their clinical course, from diagnosis to end of life. Physicians report a wide range of reasons for using treatment-oriented language in conversations with patients who have incurable cancer. However, physicians also reported concerns that this language can be ambiguous, can convey unintended positive prognostic information, and can shift attention away from important matters such as the non-curative nature of treatment or the inevitability of death. On the basis of these concerns, physicians should (1) consider whether their aims in using treatment-oriented language can be better achieved using other evidence-based communication strategies, and (2) recognize and proactively mitigate potential adverse effects of treatment-oriented language, which may manifest much later in the patient's clinical course.
医生使用以治疗为导向的语言向患者传达其癌症有治疗方法（例如，“我们对此的常规治疗方法是……”，“我们可以治疗这个”，“你的癌症仍然可以治疗”）。对于患有无法治愈癌症的患者，尤其是预后较差或处于生命末期的患者，了解医生如何构思和使用这种“日常”临床语言很重要。我们对一组多学科医生（n = 30）进行了定性访谈研究，这些医生可能在患者临床过程的不同阶段，从诊断到生命末期，照顾癌症患者。医生报告了在与患有无法治愈癌症的患者交谈中使用以治疗为导向语言的多种原因。然而，医生也报告了担忧，即这种语言可能含糊不清，可能传达意外的积极预后信息，并且可能将注意力从重要事项上转移开，例如治疗的非治愈性质或死亡的必然性。基于这些担忧，医生应该：（1）考虑使用其他循证沟通策略是否能更好地实现他们使用以治疗为导向语言的目的；（2）认识到并积极减轻以治疗为导向语言的潜在不利影响，这种影响可能在患者临床过程的后期才显现出来。
