Taylor K M, Macdonald K G, Bezjak A, Ng P, DePetrillo A D
Department of Administrative Studies, York University, North York, Ontario, Canada.
Qual Life Res. 1996 Feb;5(1):5-14. doi: 10.1007/BF00435963.
There is an implicit assumption that physicians incorporate quality of life (QOL) information in clinical decision-making. However, very limited data exists on how physicians view QOL information and how they actually use it. To explore this issue, an in-depth study was conducted using a semi-structured interview guide, with 60 oncologists in Canada and the USA. While the majority of respondents perceived QOL as important they reported a tendency to use it informally and not in all situations. Key findings include the belief expressed by 88% of respondents that the term QOL could be defined, although they differed in their definitions. Although 85% stated that QOL can be formally measured, only a third perceived that the current instruments provide valid and reliable data. Respondents noted a number of significant benefits and drawbacks of using QOL data in their clinical practice that had not been previously noted in the literature. For example, its use as an endpoint in clinical trials was generally perceived to enhance both physician and patient participation. A drawback noted was that including QOL might adversely affect the decision-making process. These findings have been used to develop a self-administered questionnaire (MD-QOL) which will test the generalizability of these findings.
有一种隐含的假设,即医生在临床决策中纳入了生活质量(QOL)信息。然而,关于医生如何看待QOL信息以及他们实际如何使用它的数据非常有限。为了探讨这个问题,使用半结构化访谈指南对加拿大和美国的60名肿瘤学家进行了深入研究。虽然大多数受访者认为QOL很重要,但他们报告说倾向于非正式地使用它,并非在所有情况下都使用。主要发现包括88%的受访者认为QOL这个术语可以被定义,尽管他们的定义有所不同。虽然85%的人表示QOL可以被正式测量,但只有三分之一的人认为当前的工具能提供有效和可靠的数据。受访者指出了在临床实践中使用QOL数据的一些显著益处和缺点,这些在以前的文献中未曾提及。例如,它在临床试验中作为一个终点通常被认为能提高医生和患者的参与度。一个指出的缺点是纳入QOL可能会对决策过程产生不利影响。这些发现已被用于开发一份自填式问卷(MD-QOL),该问卷将测试这些发现的普遍性。