癌症儿童,父母和瘤学家之间关于预后的沟通偏好
Caroline Christianson1, Calliope Reeves2, Harmony Farner3
1Division of Pediatric Hematology/Oncology, NYU Langone Health, New York City, New York.
JAMA network open
|April 16, 2025
概括
儿童癌症患者,家长和瘤学家希望讨论预后偏好. 参与者建议在披露之前询问沟通偏好,以支持福祉并提供个性化的信息.
科学领域:
- 儿科瘤学 儿科瘤学
- 临床传播 临床沟通
- 癌症护理 癌症护理
背景情况:
- 在艰难的对话之前,儿科瘤学家通常不会与患者和家长讨论预后偏好.
- 了解患者,家长和瘤学家对预后披露的看法是研究不足的.
研究的目的:
- 探索和描述儿科癌症患者,家长和瘤学家关于如何引发预后披露的沟通偏好在晚期癌症中的建议.
主要方法:
- 一项定性研究,在2022-2023年期间,对85名参与者 (25名患者,40名家长,20名瘤学家) 进行一次性采访.
- 参与者从一个学术儿科癌症中心和五个州的附属中心招募.
- 采访是在晚期疾病的各个阶段进行的,并使用患者与临床医生的沟通框架进行分析.
主要成果:
- 几乎所有参与者都希望预后披露,许多人甚至在没有明确要求的情况下也倡导这一点,理由是对专家的信任和需要保持了解.
- 大多数患者和家长,以及一些瘤学家,都强调提前引起沟通偏好,重视个性化的信息和保护情感福祉.
- 推引出偏好的策略包括提出问题,提供选择,并考虑交付和语气.
结论:
- 患者,家长和瘤学家建议主动提取在晚期儿科癌症中预后披露的偏好.
- 这些发现可以为开发干预措施提供信息,以支持个性化的预后沟通.
- 改善关于预后的沟通对于儿童瘤学中以患者为中心的护理至关重要.
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