ABSTRACT
Purpose This study aimed to analyze the content of counseling between cancer patients and physicians during outpatient follow-up, assess the duration of different communication content, and explore the influencing factors. Patients and methods We observed consecutive cancer patients without a first diagnosis of malignancy who presented to the oncology outpatient clinic of a public hospital from October through December 2023. A structured observation form was used to record the content and duration of doctor-patient communication. All variables were electronically recorded and stored on a data management platform. Multiple linear regression was used to examine the determinants of consultation duration. Results Our study included 620 cancer patients, of whom 281 individuals had distant metastasis. The average consultation duration for 620 cancer patients was 4.85 minutes (standard deviation of 3.09 minutes). The category of doctor-patient communication was routine outpatient follow-up, involving 182 patients, with an average consultation duration of 3.81 minutes (standard deviation of 2.24 minutes). The main communication content for 51 patients was about the admission procedures, with an average consultation duration of 3.00 minutes (standard deviation of 1.92 minutes). For 67 patients, the primary communication involved the prescription of anti-tumor medications, with an average consultation duration of 3.70 minutes (standard deviation of 2.30 minutes). Symptom control discussions were the main communication content with 107 patients, with an average consultation duration of 5.91 minutes (standard deviation of 3.44 minutes). The main communication content of 24 patients involved medical insurance reimbursement, with an average duration of 7.75 minutes (standard deviation of 4.63 minutes). Consultations accompanied by caregivers and the presence of metastatic tumors were positively associated with consultation duration, whereas female patients with genital malignancies were negatively associated with consultation duration. Communication about symptom management and communication about medical insurance reimbursement was positively associated with the duration of medical consultations. Communication about administering the formalities requisite for patient admission was negatively associated with the consultation duration. Conclusion We classified the main contents of doctor-patient communication in the oncology outpatient clinic and found that the contents of doctor-patient communication tended to be monotone and systematized. Oncology outpatient models should consider the integration of caregiver involvement. The reason for the shorter outpatient consultation duration in female patients of cancer primary in the reproductive system needs further investigation. The intricate medical insurance reimbursement process poses an increasing time challenge for outpatient clinicians. In addition, the adequacy and effectiveness of symptom management services provided to cancer patients during oncology outpatient follow-up require further evaluation and review.
ABSTRACT
Background: Patients with hepatobiliary or pancreatic cancers often experience severe symptoms, resulting in a sharp decline in functioning, poor quality of life, and increased mortality risk. Early and effective management of symptoms allows a better quality of life and reduced mortality, depending on the selection of appropriate assessment of specific symptoms for a defined purpose. We aimed to develop a symptom measurement item bank for hepatobiliary or pancreatic cancers. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was applied to organize this systematic review. The articles validated patient-reported outcome measures (PROMs) for hepatobiliary or pancreatic cancer and published before December 2021 were retrieved from the Web of Science, PubMed, Embase databases and Cochrane Library. Items from the existing PROMs were selected and classified into different patient-reported symptoms based on the concepts and specific underlying constructs of the objects measured. Results: Sixteen unique PROMs were identified across the 29 eligible studies included in our analysis. Items from the literature review (14 PROMs with 421 items for which information was obtained) were selected and classified. As a result of this study, we developed a symptom item bank with 40 patient-reported symptoms and 229 assessment items for hepatobiliary or pancreatic cancer, and fatigue, pain and nausea were the most common symptom items. Conclusion: We developed an item bank to assess the patient-reported symptoms of hepatobiliary or pancreatic cancer. This item bank could allow researchers to select appropriate measures of symptom and provide a basis for the development of a single-item symptom-measurement system.