影响乳腺癌手术决策的因素:日本的一项多中心研究
Hirohito Seki1, Takako Komiya2, Yoshihiro Sowa3
1Department of Breast Surgery, NHO Tokyo Medical Center, Tokyo, Japan.
概括
外科医生的意见,对复发的恐惧和伴侣的意见显著影响日本患者的乳腺癌手术选择. 根据个人的价值观做出决定,并让医疗团队参与,对于有效的共同决策 (SDM) 至关重要.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 健康心理学 心理健康心理学
背景情况:
- 共享决策 (SDM) 在癌症治疗规划中变得越来越重要,整合了患者的价值观和社会因素.
- 了解日本乳腺癌患者手术选择的决定因素至关重要,但仍不清楚.
研究的目的:
- 确定影响不同乳腺癌手术的日本患者手术决策的因素.
- 探索社会人口统计学,心理社会和医疗保健提供者因素对手术选择的影响.
主要方法:
- 这是一项多中心的横截面研究,涉及577名经过乳房切除术 (MT),乳房保护手术 (BCS) 或立即乳房重建 (IBR) 的日本患者.
- 通过问卷评估患者报告的结果和影响因素;从医疗记录中提取临床数据.
- 多变量分析确定了与选择特定手术程序相关的因素.
主要成果:
- 外科医生的意见 (92.2%) 是主要因素,其次是恐惧复发 (43.8%) 和伴侣的意见 (35.5%).
- 合作伙伴的意见显著影响BCS和IBR,而不是MT (P=0.012).
- 担心复发是MT选择的关键驱动因素 (P=0.002),而护士的意见与IBR有关.
结论:
- 手术决策因素在不同手术过程中有所不同,需要个性化的方法,考虑到患者的价值观和生活方式.
- 提高SDM需要量身定制的支持系统和医疗团队的全面参与.
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