关于局部食道癌治疗的决策:临床医生的沟通行为变化的观察研究
L F van de Water1,2,3,4, G C Scholten1,2, I Henselmans2,3,4
1Department of Medical Oncology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands.
MDM policy & practice
|July 3, 2025
概括
医疗保健提供者在讨论局部食道癌的治疗选择和患者参与方面表现出显著的差异. 需要更多的多学科协调,以改善共享决策和患者护理.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 医学沟通 医学沟通
背景情况:
- 局部食道癌提供了多种治疗治疗选择,导致复杂的决策.
- 治疗决策涉及一个多学科的医疗保健提供者 (HCP) 团队,他们有着不同的观点.
- 在这些咨询期间了解医疗保健专家的沟通对于改善患者护理至关重要.
研究的目的:
- 描述医疗保健提供者在局部食道癌患者的治疗决策咨询期间如何沟通.
- 评估患者参与决策过程的程度.
- 识别治疗选择呈现的变化及其相关风险和益处.
主要方法:
- 来自SOURCE试验的20个录音,脚本标准化患者评估 (SPA) 的分析.
- 使用开放编码方法编码记录的内容.
- 使用OPTION-12工具测量患者参与度.
主要成果:
- 医疗保健提供者讨论了一系列有限的治疗选择 (五分之1-4),以及副作用 (二十八分之0-11).
- 在呈现选择时观察到不同的方法,许多提供商隐式或明确地表示偏好.
- 平均OPTION-12得分为40.11,这表明患者参与度有很大差异.
结论:
- 在患者参与和提供关于局部食道癌治疗选择的信息方面存在显著的实践差异.
- 治疗选择的数量和类型,以及它们的优缺点,在提供者之间存在很大差异.
- 调查结果强调了在瘤医疗保健提供者之间加强多学科协调的必要性.
相关概念视频
Barrett Esophagus-II: Clinical Manifestations and Management
315
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
315
Cancer Survival Analysis
457
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
457
Esophageal Varices-II: Clinical Features and Management
147
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
147
Esophageal Strictures-II: Clinical Features and Management
162
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
162
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
276
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
276
Gastroesophageal Reflux Disease II: Clinical Features and Management
218
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
218


