Sainio C, Lauri S, Eriksson E
University of Turku, Finland.
Nurs Ethics. 2001 Mar;8(2):97-113. doi: 10.1177/096973300100800203.
The purpose of this study was to explore the views and experiences of adult cancer patients about patient participation in care and decision making and the preconditions for this participation. The data were collected by means of focused interviews; in addition the patients completed depression and problem-solving instruments. The sample comprised 34 cancer patients from the haematological and oncological wards of one university hospital in Finland. The results revealed considerable variation in the patients' views on their participation in care and decision making. Some of the patients understood participation either in terms of contributing to the decision making or in terms of expressing their views on treatment options. Some considered that their participation in care was impossible. Patient participation in care and decision making was promoted by good health, access to information, assertiveness, good interactive relationships with nurses and physicians, and encouragement by nurses and physicians to participate. Factors restricting such patient participation were poor health, ignorance, anxiety, age, time pressures of staff, lack of time, high staff turnover and poor interactive relationships. With regard to participation in medical decision making, the patients were divided into three groups: (1) active participants (n = 7), (2) patients giving active consent (n = 9), and (3) patients giving passive consent to medical decisions (n = 18).
本研究的目的是探讨成年癌症患者对患者参与护理和决策的看法与经历，以及这种参与的前提条件。数据通过聚焦访谈收集；此外，患者还完成了抑郁和解决问题的测评工具。样本包括来自芬兰一家大学医院血液科和肿瘤科病房的34名癌症患者。结果显示，患者对其参与护理和决策的看法存在很大差异。一些患者认为参与是指对决策做出贡献或就治疗选择表达自己的观点。一些患者则认为他们无法参与护理。良好的健康状况、获取信息的机会、坚定自信、与护士和医生良好的互动关系以及护士和医生的鼓励促进了患者参与护理和决策。限制患者参与的因素包括健康状况不佳、无知、焦虑、年龄、工作人员的时间压力、时间不足、人员流动率高以及互动关系不佳。在参与医疗决策方面，患者分为三组：（1）积极参与者（n = 7），（2）主动同意者（n = 9），以及（3）对医疗决策被动同意者（n = 18）。
