医生如何在晚期肺癌咨询中提出治疗选择:对话分析研究
Andrea Bruun1,2, Pål Gulbrandsen3,4, Øystein Fløtten5,6
1Marie Curie Palliative Care Research Department, UCL, London, UK a.bruun@kingston.ac.uk.
BMJ open respiratory research
|January 20, 2026
概括
医生使用各种策略来提出肺癌治疗选择,影响共享决策 (SDM). 对这些方法的认识对于有效的患者沟通和支持SDM至关重要.
科学领域:
- 在瘤学瘤学.
- 医学沟通 医学沟通
- 医疗保健服务研究 医疗服务研究
背景情况:
- 共享决策 (SDM) 需要清楚地介绍治疗选择.
- 有效的沟通对于患者参与晚期肺癌护理至关重要.
研究的目的:
- 探索医生如何向晚期肺癌患者提供治疗选择.
- 分析呈现策略对共享决策的影响.
主要方法:
- 分析了12个音频录制的晚期肺癌咨询.
- 用于对转录的数据进行对话分析.
- 从2019年11月至2022年3月期间从挪威医院收集的数据.
主要成果:
- 医生使用了三个主要策略:开放式,选择式和推式的选择表现.
- 开放式的展示需要对所有选项进行平衡的披露.
- 选择性呈现遗漏了某些选项 (例如,没有进一步的治疗),而推呈现显示了医生偏好.
结论:
- 不同的演示策略在不同程度上促进SDM.
- 一些策略可能会挑战SDM的核心原则,例如选择意识.
- 医生需要注意他们的演示策略,以有效地支持SDM.
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