Tattersall M H, Butow P N, Griffin A M, Dunn S M
Department of Cancer Medicine, University of Sydney, NSW, Australia.
J Clin Oncol. 1994 Jun;12(6):1305-11. doi: 10.1200/JCO.1994.12.6.1305.
Despite reports of poor patient understanding and recall after cancer consultations, few doctors provide communication aids. We conducted a randomized trial comparing an audiotape of the consultation versus individualized summary letters to patients after their first consultation with a medical oncologist.
One hundred eighty-two cancer patients were randomized to receive either (1) the audiotape followed 7 to 10 days later by the letter or (2) the letter followed by the audiotape. Outcome measures included patient recall, anxiety and depression, satisfaction with and use of the communication aids, and patient preferences for six communication options. Demographic and disease variables and information and involvement preferences were documented.
Eighty percent of patients wanted all information and 72% wanted to participate in treatment decisions. Patients listened to the tape on average 2.3 times and read the letter 2.8 times over 4 weeks, and 90% showed the tape or letter to a friend, relative, or doctor. Satisfaction with the tape and letter were uniformly high and they did not differentially affect recall, anxiety, or depression. When asked to rank six communication options, 46% of patients gave the highest rank to the tape and 21% to the letter.
Patients use audiotapes of their cancer consultation and individualized letters to review the information given and communicate information to relatives and friends. They prefer audiotapes to letters. Clinicians should consider installing audiotape-recording facilities that could be used to tape new-patient consultations.
尽管有报道称癌症会诊后患者的理解和记忆情况不佳，但很少有医生提供沟通辅助工具。我们进行了一项随机试验，比较会诊录音带与初次会诊后给患者的个性化总结信。
182名癌症患者被随机分为两组，一组先在7至10天后收到信，另一组先收到录音带，然后收到信。结果测量包括患者的记忆、焦虑和抑郁、对沟通辅助工具的满意度和使用情况，以及患者对六种沟通方式的偏好。记录了人口统计学和疾病变量以及信息和参与偏好。
80%的患者希望获得所有信息，72%的患者希望参与治疗决策。在4周内，患者平均听录音带2.3次，阅读信件2.8次，90%的患者将录音带或信件展示给朋友、亲戚或医生。对录音带和信件的满意度都很高，它们对记忆、焦虑或抑郁没有差异影响。当被要求对六种沟通方式进行排名时，46%的患者将录音带排在首位，21%的患者将信件排在首位。
患者使用癌症会诊录音带和个性化信件来回顾所提供的信息，并与亲戚和朋友交流信息。他们更喜欢录音带而不是信件。临床医生应考虑安装可用于录制新患者会诊的录音设备。
