Butow Phyllis, Harrison James D, Choy Ellis T, Young Jane M, Spillane Andrew, Evans Alison
School of Psychology, University of Sydney, Sydney, New South Wales, Australia.
Cancer. 2007 Nov 1;110(9):1937-44. doi: 10.1002/cncr.23007.
The aim was to obtain the views of health professionals and patients about the concept of involving breast cancer patients in the multidisciplinary (MD) treatment planning meeting.
Breast cancer surgeons, nurses, oncologists, and patient advocates completed a mailed questionnaire.
The majority of breast cancer health professionals and patient advocates support shared decision-making (58%-62%). However, less than a third of surgeons (32%), medical (25%), and radiation oncologists (24%) were supportive of involving women in the MD treatment planning meeting. In contrast, 93% of breast cancer advocates and 73% of breast cancer nurses were supportive of this approach. Patient advocates were significantly more in favor than all other groups (chi(2) = 148.8, df = 4, P < .001). The common reasons for supporting patient involvement included that it would lead to patients being more informed and empowered, provide them with an opportunity to ask questions, facilitate decision-making, and improve communication between the patient and the medical team. Health professionals stated that attendance would make patients anxious and that they would have to modify their medical language. Suggestions about how to manage patient involvement included the patient being supported by a breast nurse and pre-education before the meeting. Patient advocates were significantly more willing to participate in a randomized controlled trial of this process compared with all other groups. (chi(2) = 155.15, df = 4, P < .001).
Despite health professional's reservations, patient advocates were highly supportive of including women in the MD meeting. Such a high demand justifies consideration of this option.
目的是了解医疗专业人员和患者对于让乳腺癌患者参与多学科治疗计划会议这一概念的看法。
乳腺癌外科医生、护士、肿瘤学家和患者权益倡导者完成了一份邮寄问卷。
大多数乳腺癌医疗专业人员和患者权益倡导者支持共同决策（58%-62%）。然而，不到三分之一的外科医生（32%）、内科医生（25%）和放射肿瘤学家（24%）支持让女性参与多学科治疗计划会议。相比之下，93%的乳腺癌权益倡导者和73%的乳腺癌护士支持这种方法。患者权益倡导者比所有其他群体明显更赞成（卡方检验=148.8，自由度=4，P<.001）。支持患者参与的常见原因包括这会使患者了解更多信息并增强能力，为他们提供提问机会，促进决策制定，并改善患者与医疗团队之间的沟通。医疗专业人员表示患者出席会使其焦虑，而且他们将不得不调整医学用语。关于如何管理患者参与的建议包括让患者得到乳腺科护士的支持以及在会议前进行预先教育。与所有其他群体相比，患者权益倡导者明显更愿意参与这一过程的随机对照试验（卡方检验=155.15，自由度=4，P<.001）。
尽管医疗专业人员有所保留，但患者权益倡导者高度支持让女性参与多学科会议。如此高的需求证明有必要考虑这一选择。
