Does it matter what you call it? A randomized trial of language used to describe palliative care services

被引:86
|
作者
Maciasz, R. M. [1 ]
Arnold, R. M. [2 ]
Chu, E. [3 ]
Park, S. Y. [4 ]
White, D. B. [5 ]
Vater, L. B. [6 ]
Schenker, Y. [2 ,7 ]
机构
[1] Univ Pittsburgh, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Div Gen Internal Med, Sect Palliat Care & Med Eth, Pittsburgh, PA 15213 USA
[3] Univ Pittsburgh, Inst Canc, Div Hematol Oncol, Pittsburgh, PA 15213 USA
[4] Univ Pittsburgh, Dept Biostat, Pittsburgh, PA 15213 USA
[5] Univ Pittsburgh, Dept Crit Care Med, Clin Res Invest & Syst Modeling Acute Illness CRI, Pittsburgh, PA 15213 USA
[6] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA 15213 USA
[7] Univ Pittsburgh, Med Ctr, Div Gen Internal Med, Pittsburgh, PA 15213 USA
基金
美国国家卫生研究院;
关键词
Palliative care; Supportive care; Advanced cancer; Communication; Oncology; CELL LUNG-CANCER; MEDICINE CONSULTATION; CLINICAL ONCOLOGY; AMERICAN SOCIETY; INCURABLE CANCER; OF-LIFE; INTEGRATION; INTERVENTION; CHEMOTHERAPY; DEFINITIONS;
D O I
10.1007/s00520-013-1919-z
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Integration of palliative care into oncology practice remains suboptimal. Misperceptions about the meaning of palliative care may negatively impact utilization. We assessed whether the term and/or description of palliative care services affected patient views. 2x2 between-subject randomized factorial telephone survey of 169 patients with advanced cancer. Patients were randomized into one of four groups that differed by name (supportive care vs. palliative care) and description (patient-centered vs. traditional). Main outcomes (0-10 Likert scale) were patient understanding, impressions, perceived need, and intended use of services. When compared to palliative care, the term supportive care was associated with better understanding (7.7 vs. 6.8; p = 0.021), more favorable impressions (8.4 vs. 7.3; p = 0.002), and higher future perceived need (8.6 vs. 7.7; p = 0.017). There was no difference in outcomes between traditional and patient-centered descriptions. In adjusted linear regression models, the term supportive care remained associated with more favorable impressions (p = 0.003) and higher future perceived need (p = 0.022) when compared to palliative care. Patients with advanced cancer view the name supportive care more favorably than palliative care. Future efforts to integrate principles of palliative medicine into oncology may require changing impressions of palliative care or substituting the term supportive care.
引用
收藏
页码:3411 / 3419
页数:9
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