Wilkins Edwin G, Lowery Julie C, Copeland Laurel A, Goldfarb Sherry L, Wren Patricia A, Janz Nancy K
Section of Plastic Surgery,University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Med Decis Making. 2006 Nov-Dec;26(6):589-98. doi: 10.1177/0272989X06295355.
Previous research suggests that patient education programs promoting shared decision making (SDM) may improve patient satisfaction and outcomes, yet controlled clinical trials are lacking. The authors evaluate the impact of an early breast cancer treatment educational video on patients' decisional preferences and behavior. Newly diagnosed stage I/stage II breast cancer patients were assigned to SDM video program or control groups in alternating months. Surveys were administered prior to the provider visit and 1 week following the treatment decision. Variables assessed included autonomy preferences, perceived involvement in care, satisfaction, and treatment choice. There were no significant intervention effects on informational/decisional preferences, anxiety, knowledge, or satisfaction. Although 25% of SDM patients chose mastectomy compared to 14% of controls, this difference was not statistically significant. Eventhough enthusiasm for SDM programs remains high among some patients and providers, this study found only modest benefits.
先前的研究表明,促进共同决策(SDM)的患者教育项目可能会提高患者满意度和改善治疗结果,但缺乏对照临床试验。作者评估了一个早期乳腺癌治疗教育视频对患者决策偏好和行为的影响。新诊断为I期/II期乳腺癌的患者被交替分配到SDM视频项目组或对照组。在患者就诊前和治疗决定后1周进行调查。评估的变量包括自主偏好、对医疗护理的感知参与度、满意度和治疗选择。在信息/决策偏好、焦虑、知识或满意度方面没有显著的干预效果。尽管25%的SDM患者选择了乳房切除术,而对照组为14%,但这种差异没有统计学意义。尽管一些患者和医疗服务提供者对SDM项目的热情仍然很高,但这项研究只发现了适度的益处。