Hubbard Gill, Kidd Lisa, Donaghy Edward
Cancer Care Research Centre, Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA, UK.
Eur J Oncol Nurs. 2008 Sep;12(4):299-318. doi: 10.1016/j.ejon.2008.03.004. Epub 2008 May 16.
A systematic review of the literature about patients' preferences for involvement in cancer treatment decision making was conducted. Establishing preferences is important if the aim is to make health care more sensitive to the needs and expectations of each individual patient. Thirty-one papers were included in the review. Generalising from this literature is problematic because of limitations related to sample size, sample composition and methods used to assess preferences. Whilst we take cognizance of these limitations, research suggests that preferences vary considerably and that whilst most patients prefer a collaborative role, a significant minority prefer a passive or active role. Evidence about the association of factors such as age, gender, level of education, marital status, socio-economic status and health status with preferences is inconclusive. Only a handful of studies investigated the degree of congruence between patients' role preferences and the actual role that they perceived they had played, which highlight that some patients experience a dissonance between the two. Similarly, few studies investigated the impact of this dissonance on patient anxiety or satisfaction with the treatment decision. We advocate more rigorous investigations before recommendations for health care professionals can be processed with confidence.
对关于患者参与癌症治疗决策偏好的文献进行了系统综述。如果目标是使医疗保健对每个患者的需求和期望更加敏感，那么确定偏好很重要。该综述纳入了31篇论文。由于样本量、样本构成以及用于评估偏好的方法等方面的局限性，从这些文献中进行归纳总结存在问题。虽然我们认识到这些局限性，但研究表明偏好差异很大，虽然大多数患者更喜欢协作角色，但相当一部分少数患者更喜欢被动或主动角色。关于年龄、性别、教育程度、婚姻状况、社会经济地位和健康状况等因素与偏好之间关联的证据尚无定论。只有少数研究调查了患者角色偏好与他们认为自己所扮演的实际角色之间的一致程度，这凸显出一些患者在两者之间存在不一致。同样，很少有研究调查这种不一致对患者焦虑或对治疗决策满意度的影响。我们主张在能够自信地为医疗保健专业人员提出建议之前，进行更严格的调查。
