Berry Donna L, Ellis William J, Russell Kenneth J, Blasko John C, Bush Nigel, Blumenstein Brent, Lange Paul H
University of Washington, Seattle, WA 98195-7266, USA.
Clin Genitourin Cancer. 2006 Dec;5(3):219-26. doi: 10.3816/CGC.2006.n.040.
Men diagnosed with localized prostate cancer (LPC) often have the opportunity to participate in the treatment choice. The purpose of this study was to evaluate relationships between influential factors on treatment choice and the decision-related outcomes of decisional conflict and satisfaction.
This report presents data from 260 men diagnosed with LPC who were identified by their clinicians as having a choice of treatments. Men completed questionnaires at home within 2 weeks of the informational clinic visit with the clinician, but before treatment. The respondent sample had a mean age of 63.2 years (standard deviation, 8.1 years); the majority were married/partnered (82.7%), working (51.5%), white (93.8%), and educated at the collegiate level (83.8%). Personal factors (information, influential people, and outcomes), treatment choice, and decisional conflict and satisfaction with the decision (SWD) were queried. Relationships between all variables and the outcomes, SWD, and treatment choice were explored using exhaustive chi(2) automatic interaction detector.
The strongest predictor partition variable for SWD was the subscale "factors contributing to uncertainty" (adjusted P < 0.0001) followed by the Trait Anxiety score (adjusted P = 0.0388). The strongest predictive partition for the actual treatment choice was age group (adjusted P < 0.0001), followed by interacting marital status (adjusted P = 0.0003), influence of the urologist (adjusted P = 0.0008), and use of the Internet (adjusted P = 0.0479). Men with LPC were more satisfied with their treatment choice when they reported fewer uncertainty factors; these are factors mainly relevant to information needed to understand the pros and cons and to make a decision. Consistent with this finding for treatment choice is the use of the Internet, though this factor interacted with age, the influence of their surgeon, and marital status.
This study suggests that personally meaningful information communicated between patients and clinicians is paramount.
被诊断为局限性前列腺癌（LPC）的男性通常有机会参与治疗选择。本研究的目的是评估影响治疗选择的因素与决策冲突和满意度等决策相关结果之间的关系。
本报告呈现了260名被诊断为LPC的男性的数据，这些男性被其临床医生认定有多种治疗选择。男性在与临床医生进行信息门诊就诊后的2周内、治疗前在家中完成问卷。应答者样本的平均年龄为63.2岁（标准差8.1岁）；大多数人已婚/有伴侣（82.7%）、有工作（51.5%）、为白人（93.8%）且受过大学教育（83.8%）。询问了个人因素（信息、有影响力的人及结果）、治疗选择以及决策冲突和对决策的满意度（SWD）。使用穷举卡方自动交互检测器探索所有变量与结果、SWD和治疗选择之间的关系。
SWD的最强预测划分变量是子量表“导致不确定性的因素”（校正P<0.0001），其次是特质焦虑得分（校正P = 0.0388）。实际治疗选择的最强预测划分是年龄组（校正P<0.0001），其次是交互婚姻状况（校正P = 0.0003）、泌尿科医生的影响（校正P = 0.0008）和互联网的使用（校正P = 0.0479）。当报告的不确定性因素较少时，LPC男性对其治疗选择更满意；这些因素主要与理解利弊和做出决策所需的信息相关。与治疗选择的这一发现一致的是互联网的使用，尽管该因素与年龄、外科医生的影响和婚姻状况存在交互作用。
本研究表明患者与临床医生之间传达的个人有意义信息至关重要。
