一个混合方法系统审查的癌症治疗决策在弱势群体
Charmaine L Blanchard1, Patricia McInerney2, Maureen Joffe1
1Strengthening Oncology Services Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Non-Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa.
Patient education and counseling
|January 22, 2026
概括
患者决策辅助工具 (PtDA) 必须为易受伤害的癌症患者量身定制,优先考虑清晰,面对面的信息传递,以有效地解决他们的情感和支持需求.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 患者的决策制定 患者的决策
背景情况:
- 易受伤害的癌症患者经常因缺乏量身定制的支持而做出不知情的治疗决定.
- 现有的患者决策辅助工具 (PtDAs) 主要是为高收入国家人口开发的,对弱势群体缺乏适应性.
- 需要了解PtDA如何更好地解决脆弱癌症患者的独特决策需求.
研究的目的:
- 系统地审查和综合关于患者决策辅助器 (PtDAs) 如何解决脆弱癌症患者的治疗决策需求的证据.
- 确定当前PTDA设计与脆弱癌症患者报告的决策支持需求之间的差距和对齐.
- 为这一群体提供推,以开发更有效的PtDA.
主要方法:
- 进行了一项混合方法的系统审查,包括随机对照试验 (RCT),PTDA的其他有效性研究和定性研究.
- 研究重点关注患有癌症的脆弱成年人 (≥18岁) 和他们的治疗决策经验.
- 数据被单独合成 (定性和定量),然后按照PRISMA指导方针进行整合.
主要成果:
- 26项研究 (14项定量研究,11项定性研究,1项混合研究) 符合纳入标准.
- 定性发现表明,弱势患者面临高情绪/心理社会负担,更喜欢面对面的支持,并经历角色决策不匹配.
- 定量调查结果显示,PtDA提高了知识 (5/7) 和减少了决策冲突 (6/7),对共享决策产生混合影响 (3/5).
结论:
- 提供清晰,简洁的信息并面对面交付的患者决策辅助工具 (PtDA) 对脆弱的患者更有效,而不是自我管理的工具.
- 没有审查的PtDAs包含结构化咨询,尽管患者报告了显著的情绪和心理社会负担.
- PtDA需要量身定制,以满足脆弱癌症患者的信息,情感和角色支持需求,特别是在资源有限的环境中.
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