临床医生和查候选人的观点,以前列腺特异抗原 (PSA) 测试进行前列腺癌查的共享决策:一种定性研究 (PROSHADE研究)
María José Sanchis1, Mercedes Guilabert2, Lucy A Parker1,3
1Department of Public Health, History of Science, and Gynecology, Miguel Hernandez University of Elche Faculty of Medicine, Sant Joan D'Alacant, Comunidad Valenciana, Spain.
BMJ evidence-based medicine
|January 11, 2025
概括
患者希望在前列腺癌 (PCa) 查中获得明确的信息,而医疗保健专业人员面临时间和协调障碍. 基于证据的工具对于有效的共享决策 (SDM) 在PSA测试中至关重要.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 使用前列腺特异性抗原 (PSA) 测试进行前列腺癌 (PCa) 查需要做出复杂的决定.
- 共享决策 (SDM) 旨在让患者参与这些选择,但观点可能有所不同.
- 了解这些观点是改善查过程的关键.
研究的目的:
- 分析患者和医疗保健专业人员对PCa查中的SDM的看法.
- 在PSA测试的背景下,识别SDM的促进者和障碍.
- 为在PCa选中支持SDM的工具的开发提供信息.
主要方法:
- 从2022年5月到12月进行了一项描述性定性研究.
- 通过六个重点小组和四次采访收集数据,对27名查候选人和33名医疗保健专业人员进行了采访.
- 使用ATLAS.ti软件进行了主题分析.
主要成果:
- 当SDM提供了明确的信息和赋权时,患者会重视SDM.
- 医疗保健专业人员对SDM的知识和实施各不相同,需要标准化的协议.
- 关于PSA测试的意见分歧;担忧包括错误阳性和侵入性手术.
- SDM的障碍包括有限的临床时间和护理层之间的协调不良.
结论:
- 患者寻求全面的信息,以便在PCa查决策中获得权力.
- 医疗保健专业人员面临的挑战包括时间限制和专业间协调问题.
- 所有利益相关者都强调需要基于证据的工具来支持SDM和PSA测试中的合作.
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