与健康有关的生活质量评估和患者与医生的沟通:一个随机对照试验
Symone B Detmar1, Martin J Muller, Jan H Schornagel
1Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
JAMA
|December 17, 2002
概括
标准化与健康相关的生活质量 (HRQL) 评估改善了患者与医生的沟通,并提高了医生对癌症护理中的患者HRQL问题的认识. 这项干预措施得到了患者和医生的好评.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 患者报告的结果
背景情况:
- 在临床实践中,人们对与健康相关的生活质量 (HRQL) 评估越来越感兴趣.
- 关于HRQL评估在日常实践中的有用性的经验数据有限.
研究的目的:
- 评估标准化HRQL评估在增强患者与医生的沟通方面的有效性.
- 确定这些评估是否提高了医生对患者HRQL问题的认识.
主要方法:
- 一项前性随机交叉试验,涉及10名医生和214名缓和化疗患者.
- 患者在三次访问中填写了HRQL问卷 (EORTC QLQ-C30);结果以图形形式总结,供医生审查.
- 通过录音带分析了沟通;使用达特斯COOP和WONCA图表比较了医生意识.
主要成果:
- 在干预组 (P=.01) 中,HRQL问题在干预组中讨论的次数明显增加 (P=.01).
- 干预组的医生发现了更多患有中度至重度HRQL问题的患者.
- 所有医生和87%的患者认为干预措施促进了沟通,并希望它继续下去.
结论:
- 标准化的HRQL评估有效地促进了在瘤学中讨论HRQL问题的讨论.
- 这些评估提高了医生对患者HRQL担忧的认识.
- 建议将其纳入临床实践.
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