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患者と医師の関係である. 外来患者による緩和治療の訪問中の患者と医師のコミュニケーション:観察研究
S B Detmar1, M J Muller, L D Wever
1Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands.
JAMA
|March 20, 2001
まとめ
緩和がん治療中の患者の生活の質 (HRQL) に関する医師のコミュニケーションは限られています. 患者によって報告されたHRQLは,議論に大きな影響を与えるが,多くの深刻な問題,特に感情的幸福感と疲労は,未解決のままである.
科学分野:
- 腫瘍学 腫瘍学
- 緩和ケアとは,緩和ケアです.
- 医療サービス 研究 医療サービス
- 医療におけるコミュニケーション
背景:
- 健康関連生活の質 (HRQL) の改善は,緩和がんケアにおける重要な目標です.
- 緩和治療中のHRQLに関する患者と医師のコミュニケーションに関する現在の理解は限られている.
研究 の 目的:
- HRQLに関する4つの特定の問題に関する,患者と腫瘍科医の日常的なコミュニケーションの内容を分析する.
- HRQLの議論に関連する患者,医師,訪問関連の要因を特定する.
主な方法:
- 外科医の緩和化学療法クリニックで観察研究が行われました.
- 10人の腫瘍科医と治療不能の癌の患者240人から,アンケートとオーディオテープ分析を用いてデータを収集した.
- ローター相互作用分析システム (Roter Interaction Analysis System) は,日常活動,感情的機能,痛み,疲労に関するコミュニケーションを分析するために使用されました.
主要な成果:
- 医師は,診察時間の64%を医療/技術的な問題に対して,23%をHRQLの問題に費やしました.
- 患者は医療/技術問題 (41%) とHRQLトピック (48%) をより平等に議論しました.
- 患者の報告したHRQLは,HRQLを議論するための最も強力な予測因子であったが,深刻なHRQL問題,特に感情的機能と疲労の20-54%は対処されなかった.
結論:
- 緩和がんケアにおけるHRQLに関する患者と医師のコミュニケーションは限られている.
- HRQLに関する明示的なコミュニケーションは,実践における治療効果評価に控えめな貢献をします.
- 患者のHRQLを改善するためのコミュニケーション戦略を強化するためにさらなる研究が必要です.
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