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癌症患者在参与治疗决策时的负担经历
Fiorella L Huijgens1,2,3, Marij A Hillen1,2,3, Mette J Huisinga1
1Department of Medical Psychology, Amsterdam UMC, Amsterdam, Netherlands.
概括
患有早期乳腺癌和前列腺癌的患者经历了治疗决策的重大负担. 这种负担源于不确定性,恐惧和缺乏指导,强调需要更好的共享决策支持.
科学领域:
- 在瘤学瘤学.
- 健康心理学 心理健康心理学
- 决策科学 决策科学 决策科学
背景情况:
- 患者参与临床决策的比例正在上升.
- 人们担心患者在决策过程中可能遭受情绪上的痛苦.
- 有限的研究解决了改变生命的治疗决策对患者的负担.
研究的目的:
- 探索早期乳腺癌和前列腺癌患者在治疗决策过程中的负担的性质和表现.
- 确定患者感知到与决策相关的负担的原因.
- 确定潜在的患者建议的解决方案,以减轻这种负担.
主要方法:
- 半结构面试对24名在过去6个月内被诊断的患者进行了半结构面试.
- 患者报告说,与参与决策相关的负担有一定程度.
- 两位独立研究人员对采访成绩单进行了诱导性主题分析.
主要成果:
- 患者在各种决策阶段经历了负担,表现在情绪,认知和身体上.
- 关键的负担贡献者包括不确定性,害怕错误的选择,不充分的临床指导和感知到的责任.
- 缓解因素包括足够的时间,专家/家庭讨论以及临床医生/家庭建议.
结论:
- 与决策相关的负担来自患者的不确定性,焦虑和共同决策中的角色偏好.
- 承认患者的痛苦和定制决策角色可以减轻负担.
- 临床医生应该促进共享决策,提供超越信息的支持,并在需要时可能保留一些控制权.
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