Systematic Screening of Advanced Cancer Patients' Curability Perception: A Longitudinal Analysis.

IF 3.5 2区 医学 Q2 CLINICAL NEUROLOGY
Kayley Ancy, Grecia Aldana Singleton, Yi Huang, Donna S Zhukovsky, Yvonne Heung, Eduardo Bruera, David Hui
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引用次数: 0

Abstract

Context: Systematic screening of illness understanding is a novel approach that normalizes discussion of this sensitive topic and helps to identify patients with information needs.

Objectives: To examine changes over time in perception of curability among patients with advanced cancer and the predictors of misperception.

Methods: We implemented universal electronic systematic screening of illness understanding for each patient in our Supportive Care Center using questions from the Prognosis and Treatment Perception Questionnaire. The current study retrospectively reviewed data from all patients with advanced solid tumors who completed screening at their consultation and at least one follow-up visit within 1 year.

Results: The analysis included 432 patients: mean age 58 years (SD 14), 248 (57.4%) female, 331 (76.6%) White. The mean number of visits to the Supportive Care Center was 2.69 (SD 0.9), and the median time between the initial consultation and second visit was 85 days (IQR 68.0-113.3). At visits 1 and 2, 34.0% (147/432) and 36.8% (159/432) of patients, respectively, had an accurate perception of curability (p=0.3). In multivariable analysis, inaccurate perception of curability at both initial consultation and second visit was associated with Asian race (OR=3.08, p=0.02), greater well-being (reverse scored, OR=0.83, p<0.001) and better sleep (OR=0.89, p=0.002), and lower fatigue (OR=0.92, p=0.02), depression (OR=0.88, p=0.001), anxiety (OR=0.9, p=0.006), and financial distress (OR=0.92, p=0.015).

Conclusion: Only one in three patients with advanced cancer had an accurate understanding of their curability, with limited improvement over time. Systematic screening may provide opportunities to improve illness understanding and coping support.

晚期癌症患者治愈认知的系统筛查:一项纵向分析。
背景:疾病理解的系统筛选是一种新的方法,使这一敏感话题的讨论正常化,并有助于识别有信息需求的患者。目的:研究晚期癌症患者对可治愈性认知随时间的变化以及误解的预测因素。方法:我们使用预后和治疗认知问卷中的问题,对我们支持护理中心的每位患者实施了疾病认知的通用电子系统筛查。目前的研究回顾性回顾了所有晚期实体瘤患者的数据,这些患者在咨询时完成了筛查,并在1年内至少进行了一次随访。结果:纳入432例患者,平均年龄58岁(SD 14),女性248例(57.4%),白人331例(76.6%)。访问支持护理中心的平均次数为2.69次(标准差为0.9),首次咨询和第二次访问之间的中位时间为85天(IQR 68.0-113.3)。在第1次和第2次就诊时,34.0%(147/432)和36.8%(159/432)的患者准确感知到治愈率(p=0.3)。在多变量分析中,首次咨询和第二次就诊时对治愈率的不准确认知与亚洲人种(OR=3.08, p=0.02)、更大的幸福程度(反向评分,OR=0.83, p)相关。结论:只有三分之一的晚期癌症患者对自己的治愈率有准确的认识,随着时间的推移改善有限。系统筛查可以提供机会,提高对疾病的理解和应对支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.90
自引率
6.40%
发文量
821
审稿时长
26 days
期刊介绍: The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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