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与患者分享肿瘤基因组测序结果:高级执业肿瘤学提供者的经验

Sharing Genomic Tumor Sequencing Results With Patients: Experiences of Advanced Practice Oncology Providers.

作者信息

Stewart Lisa, Koci Anne Floyd, Lowe Tracy Brock, Patterson Wesley G, Farrell Christopher L, Withycombe Janice S

机构信息

From Clemson University, Clemson, South Carolina.

出版信息

J Adv Pract Oncol. 2024 Nov 4:1-10. doi: 10.6004/jadpro.2024.15.8.17.

Abstract

BACKGROUND

Patients with cancer routinely undergo genomic tumor sequencing, a component of molecular profiling (MP), to better characterize their cancer and identify potential targetable alterations. Targeted treatments potentially confer higher response rates and better efficacy. With increasing complexity, patients may require detailed explanations of MP results. Patient understanding of MP results increases the likelihood that eligible patients receive targeted treatment. Advanced practice providers (APPs), defined as nurse practitioners, physician assistants, and pharmacists, frequently review and discuss MP results with patients. Purpose: The aim of this study is to understand APP experiences discussing MP results with adult cancer patients.

METHODS

A qualitative study was conducted through virtual semi-structured interviews with APPs recruited via study invitation shared through the Advanced Practitioner Society for Hematology and Oncology (APSHO). Eligibility criteria included APPs with > 1 year of oncology experience and involvement in discussing MP results. Data were analyzed utilizing a constant comparative analysis and coded in three stages: open, axial, and selective.

RESULTS

Thirteen participants were enrolled from across the United States. Participants discussed learning to understand and explain MP findings primarily through on-the-job experiences. Barriers to patient education were also described. Initially coded participant statements (open codes) produced six themes (axial codes).

CONCLUSIONS

With MP now standard practice in oncology, APPs frequently discuss these results with patients. This study highlights that additional and continuing education related to MP is needed in communicating complex results. Patient educational tools, specific to patients' MP findings and tailored to their preferences and literacy levels, are critically needed.

摘要

背景

癌症患者通常会接受基因组肿瘤测序,这是分子谱分析(MP)的一个组成部分,以便更好地描述其癌症特征并识别潜在的可靶向改变。靶向治疗可能会带来更高的缓解率和更好的疗效。随着复杂性的增加,患者可能需要对MP结果进行详细解释。患者对MP结果的理解增加了符合条件的患者接受靶向治疗的可能性。高级执业人员(APPs),定义为执业护士、医师助理和药剂师,经常与患者一起审查和讨论MP结果。目的:本研究的目的是了解APPs与成年癌症患者讨论MP结果的经历。

方法

通过虚拟半结构化访谈对通过血液学和肿瘤学高级执业人员协会(APSHO)共享的研究邀请招募的APPs进行了一项定性研究。纳入标准包括有超过1年肿瘤学经验且参与讨论MP结果的APPs。数据采用持续比较分析进行分析,并分三个阶段编码:开放编码、轴心编码和选择编码。

结果

来自美国各地的13名参与者被纳入研究。参与者主要通过在职经验讨论如何学习理解和解释MP结果。还描述了患者教育的障碍。最初编码的参与者陈述(开放编码)产生了六个主题(轴心编码)。

结论

随着MP现在成为肿瘤学的标准做法,APPs经常与患者讨论这些结果。本研究强调,在传达复杂结果时,需要与MP相关的额外和持续教育。迫切需要针对患者MP结果、根据其偏好和识字水平量身定制的患者教育工具。

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The State of Genetics and Genomics Education in US Physician Assistant Programs.美国医师助理项目中遗传学和基因组学教育的现状。
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