Lam Wendy, Fielding Richard, Chan Miranda, Chow Louis, Ho Ella
Center for Psycho-Oncology Research and Teaching, Department of Community Medicine, University of Hong Kong, Pokfulam, Hong Kong SAR, China.
Breast Cancer Res Treat. 2003 Jul;80(2):171-80. doi: 10.1023/A:1024568732213.
To report Chinese women's preferred and perceived participation in breast cancer treatment decision making (TDM), describe influences on women's participation preference and participation congruence (PC) (correspondence between preferred and actual amount of participation in TDM), and explore subsequent satisfaction with TDM.
Of 172/211 eligible and available Chinese women recently undergoing breast cancer surgery at one of six Hong Kong government hospitals 154 (89.5%) were recruited. Within 12 days after surgery, women provided interview information on preferred and perceived TDM participation, satisfaction with TDM consultation, difficulties in TDM, and medical and demographic information.
Half (55%) reported a treatment choice: 33% wanted the choice to be their own, 59% wanted to share and 8% wanted to delegate the decision. Only age predicted participation preference with older women preferring a more passive role. Eighty percent of women participated as much as, 13% more than and 6% less than desired. Adjusted for age, women reporting PC had fewer difficulties in TDM (beta = 0.21, p = 0.009) than women not reporting PC, while over-involved women had more doubts about their choice (beta = -0.23, p = 0.005). PC was associated with being offered a treatment option (chi2 = 15.59, p < 0.001) and surgeons expressing a surgical preference (chi2 = 6.63, p = 0.036). Satisfaction was unrelated to PC.
Most Chinese women want shared TDM and to know their surgeon's treatment preference. Over-involved women are at greater risk of difficulties and doubts in TDM and under-involved women perceive a lack of time and information to make their decision.
报告中国女性在乳腺癌治疗决策制定（TDM）中偏好的及实际参与的情况，描述影响女性参与偏好及参与一致性（PC）（TDM中偏好的参与程度与实际参与程度之间的对应关系）的因素，并探讨对TDM的后续满意度。
在香港六家政府医院之一近期接受乳腺癌手术的211名符合条件且可联系到的中国女性中，172名符合条件，招募了其中154名（89.5%）。术后12天内，女性提供了关于TDM偏好及实际参与情况、对TDM咨询的满意度、TDM中的困难以及医疗和人口统计学信息的访谈资料。
一半（55%）的女性报告有治疗选择：33%希望自己做出选择，59%希望共同参与，8%希望将决策委托他人。只有年龄可预测参与偏好，年龄较大的女性更倾向于被动角色。80%的女性参与程度与期望相同，13%高于期望，6%低于期望。校正年龄后，报告有PC的女性在TDM中遇到的困难（β = 0.21，p = 0.009）少于未报告有PC的女性，而参与过度的女性对自己的选择有更多疑虑（β = -0.23，p = 0.005）。PC与获得治疗方案（χ² = 15.59，p < 0.001）以及外科医生表达手术偏好（χ² = 6.63，p = 0.036）相关。满意度与PC无关。
大多数中国女性希望共同参与TDM并了解外科医生的治疗偏好。参与过度的女性在TDM中遇到困难和产生疑虑的风险更大，而参与不足的女性认为缺乏做出决策的时间和信息。
