了解影响共享决策的因素围绕手术切除低风险甲状腺癌:一项前性定性研究
Wanding Yang1,2,3, Oliver Skan1, Simon N Rogers4
1Department of Otolaryngology, University College London Hospital, London, United Kingdom.
Thyroid : official journal of the American Thyroid Association
|December 30, 2025
概括
患有低风险差异化甲状腺癌 (LRDTC) 的患者需要针对性信息来做出手术决定. 共享决策需要平衡患者的偏好与临床建议,以获得最佳的治疗选择.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 外科手术决策的制定能力
背景情况:
- 国际指导方针提倡针对低风险差异化甲状腺癌 (LRDTC) 治疗的个性化方法.
- 有效的信息共享对于明智的患者决策至关重要,而不会导致信息过载.
- 了解LRDTC的决策因素对于以患者为中心的护理至关重要.
研究的目的:
- 探索患者和临床医师在LRDTC的信息共享和决策方面的观点.
- 确定影响治疗选择的关键因素,包括甲状腺切除术,全甲状腺切除术和积极监测.
- 为LRDTC管理制定决策支持工具提供信息.
主要方法:
- 半结构面试与19名患者和8名临床医生 (外科医生和护士专家) 在两个英国的三级中心.
- 通过多学科团队会议招募了新诊断为LRDTC (1-4厘米,没有不良特征) 的患者.
- 使用框架方法对采访成绩单进行了专题分析.
主要成果:
- 信息传递往往被认为是压倒性的;患者更喜欢量身定制,简洁的信息.
- 患者的决策受到减少手术,保护甲状腺,避免激素替代和接受复发风险的愿望的影响.
- 虽然患者的自主权得到了重视,但临床医生的建议显著影响了选择;一些临床医生倾向于多学科团队 (MDT) 决策而不是患者选择.
结论:
- 确定了LRDTC治疗决策的基本信息需求,支持决策支持工具的开发.
- 多维度治疗讨论可能需要调整,以更好地支持个性化的患者决策和偏好.
- 在管理LRDTC时,平衡患者自主权与临床专业知识是关键.
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