Objectives: To investigate communication clarity and understanding at the time of pancreatic adenocarcinoma (PDAC) diagnosis and whether they can influence patient engagement and compliance. Consecutive PDAC patients were enrolled at the time of diagnosis after obtaining informed consent in a single-center study. The patients completed a validated scale (PHE-s®), and the understanding rate was assessed using standardized tools. Patient compliance was evaluated, and the correlation between the PHE-s®, understanding, and compliance was calculated. Thirty patients were enrolled (15 female) with a mean age 64.4, 13 were metastatic. The mean visit time was 31 min, being longer if visiting doctor was an oncologist (p = 0.002). The engagement level was high in 70% of the patients, and all but one were compliant. The analysis of doctor-patient interactions showed a median of 121 conversational turns for doctors, 75 for patients, and 20 for caregivers (p < 0.0001), and the median percentage of speaking time was 77% for doctors, 13% for patients, and 2% for caregivers (p < 0.0001). Female caregivers spent more time speaking than did male caregivers (median 11.6% vs. 1.3%; p = 0.06). There were 290 instances of problematic understanding, most of which occurred during the taking of patients' personal medical history for doctors, while for patients and caregivers, these occurred mainly during the discussion of diagnosis/treatment (p < 0.0001). In a multivariable analysis, only origin from central or southern Italy was associated with high engagement (p = 0.0087). In this first attempt to measure clarity of communication and engagement in patients with PDAC, typical features of conversation and problematic understanding emerged, which deserves further investigation.

中文翻译：

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胰腺癌患者在诊断时的沟通、理解和参与

目的：调查胰腺癌 (PDAC) 诊断时沟通的清晰度和理解，以及它们是否会影响患者的参与和依从性。在一项单中心研究中获得知情同意后，在诊断时连续​​招募 PDAC 患者。患者完成了验证量表 (PHE-s®)，并使用标准化工具评估理解率。评估患者的依从性，并计算 PHE-s®、理解和依从性之间的相关性。共有 30 名患者入组（15 名女性），平均年龄 64.4 岁，其中 13 名患者发生转移。平均就诊时间为 31 分钟，如果就诊医生是肿瘤科医生，则时间会更长 (p = 0.002)。 70% 的患者参与度很高，除一名患者外，所有患者均遵守规定。对医患互动的分析显示，医生的中位对话次数为 121 次，患者为 75 次，护理人员为 20 次（p < 0.0001），医生的中位说话时间百分比为 77%，患者为 13%，护理人员为 2% (p < 0.0001)。女性看护者比男性看护者花更多的时间说话（中位数 11.6% vs. 1.3%；p = 0.06）。存在 290 起理解问题的案例，其中大多数发生在医生获取患者个人病史的过程中，而对于患者和护理人员来说，这些问题主要发生在诊断/治疗的讨论过程中 (p < 0.0001)。在多变量分析中，只有来自意大利中部或南部的人与高参与度相关 (p = 0.0087)。在首次尝试衡量 PDAC 患者的沟通清晰度和参与度时，出现了典型的对话特征和有问题的理解，值得进一步研究。