"挑战在于复杂性" - - 一项关于高级肺癌治疗决策的定性研究
Silje Orstad1, Øystein Fløtten2, Tesfaye Madebo3
1Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
Lung cancer (Amsterdam, Netherlands)
|July 23, 2023
概括
开发用于晚期肺癌治疗的决策辅助工具是一项挑战. 患者和临床医生需要在共享决策中更好地支持信息交换,自治和管理不确定性.
科学领域:
- 在瘤学瘤学.
- 医疗决策的制定 医疗决策的制定
- 医疗保健服务研究 医疗服务研究
背景情况:
- 共享决策和决策辅助 (DA) 是有价值的,但很难在临床实践中实施.
- 在一线治疗后的高级肺癌治疗决策面临着独特的挑战.
研究的目的:
- 调查晚期肺癌治疗决策的需求和挑战.
- 在这种情况下,评估决策辅助 (DA) 的适用性.
主要方法:
- 从与患者,亲属,护士和医生组成的半结构焦点小组中收集的定性数据.
- 对来自挪威四家医院的12名患者,7名亲属,12名护士和18名医生的数据进行了系统的文本凝聚分析.
主要成果:
- 关键的决策因素包括临床医生与患者关系的连续性,信息交换障碍,自主谈判和管理不确定性.
- 临床医生对DA的时间限制和无法捕捉复杂性表示担忧;患者希望获得更多信息和对繁重疗法的选择.
- 参与者更喜欢加强沟通的干预措施,为连续性提供组织支持,以及减少治疗不确定性的工具.
结论:
- 在一线治疗后,为晚期肺癌开发一种普遍适用的决策辅助工具是复杂的,因为利益相关者的需求不同.
- 需要全面的决策支持干预措施,解决组织结构,沟通培训 (包括不确定性) 和患者脆弱性/毒性评估.
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