与肺癌黑人患者在常规瘤诊所的共同决策
Katarina E AuBuchon1, Amanda Khoudary2, Jennifer D Rodriguez1
1Department of Oncology, Georgetown University, Washington, DC, USA.
概括
患者报告的癌症护理共享决策 (SDM) 与黑人患者更好的满意度和症状管理相关. 编码的SDM与患者报告不一致,突出了通信复杂性.
科学领域:
- 在瘤学瘤学.
- 健康 公平 卫生 公平
- 患者与医疗服务提供者之间的沟通
背景情况:
- 临床医生与患者的不良沟通可能会加剧癌症症状负担的种族差异.
- 共享决策 (SDM) 可以改善沟通,促进黑人癌症患者的健康公平.
- 有限的研究存在于SDM专门针对黑人癌症患者.
研究的目的:
- 检查晚期肺癌患者在常规瘤学随访期间的共享决策 (SDM).
- 研究SDM,患者满意度和癌症黑人患者的症状严重程度之间的关系.
- 将编码的SDM与患者和临床医生报告的SDM进行比较.
主要方法:
- 多方法纵向观察性研究,涉及临床医生 (n=6),黑人患者 (n=30) 和记录的访问 (n=20).
- 在晚期肺癌随访中,在症状管理对话中分析SDM.
- 用于评估SDM,患者满意度和症状严重程度之间的关系的双面相关性.
主要成果:
- 大多数患者讨论了症状 (95%),特别是疼痛/神经病变 (65%).
- 在症状讨论期间编码的SDM很低,与患者和提供者报告的高SDM形成鲜明对比.
- 患者报告的SDM,非编码的SDM,与更高的预约后满意度和一个月后更低的症状负担相关.
结论:
- 编码的SDM与瘤学预约中的患者和医生报告的SDM不一致.
- 患者报告的SDM与黑人癌症患者改善的健康结果和满意度有关.
- 需要进一步的研究来开发文化相关的方法来评估SDM和解决黑人患者的沟通需求.
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