Feldman-Stewart Deb, Brennenstuhl Sarah, Brundage Michael D
Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Canada.
Patient Educ Couns. 2008 Dec;73(3):437-42. doi: 10.1016/j.pec.2008.07.008. Epub 2008 Aug 30.
To compare information needs for decision-making by similar cohorts of Canadian early-stage prostate cancer patients, at two time points a decade apart.
Two patient groups (1st-1996, 2nd-2005), diagnosed within the previous 2 years, were surveyed. They rated the importance of having each of 92 questions addressed, using options: essential, desired, no opinion, or avoid. For each essential or desired question, respondents indicated their reasons for wanting the question addressed: to understand, decide, plan, or other.
The two groups had similar response rates and demographics. The mean number of questions rated essential for decision-making/patient trended toward more by the later group (13 questions vs 19 questions) but, more importantly, there was wide variation within each group (0-68 questions vs 0-92 questions). The percentage of essential ratings for decision-making per question was highly correlated between the groups. Although almost every question was essential for decision-making to >1 patient, no question was essential to >50% in either group.
At both times, most Canadian early-stage prostate cancer patients wanted some information specifically for decision-making, however, both the amount and exact details varied considerably amongst patients.
Decision support for these patients should continue to accommodate wide variation in their information needs.
比较相隔十年的两个时间点上,加拿大早期前列腺癌患者类似队列在决策时的信息需求。
对两组患者(第一组-1996年,第二组-2005年)进行调查,这两组患者均在过去两年内被诊断出病情。他们使用以下选项对92个问题逐一进行重要性评级:必不可少、希望了解、无意见或应避免。对于每个必不可少或希望了解的问题,受访者需表明希望该问题得到解答的原因:为了理解、决策、规划或其他原因。
两组的回复率和人口统计学特征相似。后一组认为对决策/患者必不可少的问题平均数量有增多趋势(13个问题对19个问题),但更重要的是,每组内部都存在很大差异(0 - 68个问题对0 - 92个问题)。两组之间每个问题对于决策的必不可少评级百分比高度相关。尽管几乎每个问题对不止一名患者来说都是决策所必需的,但在任何一组中,没有一个问题对超过50%的患者是必不可少的。
在两个时间点上,大多数加拿大早期前列腺癌患者都希望获得一些专门用于决策的信息,然而,患者之间在信息量和具体细节方面差异相当大。
对这些患者的决策支持应继续适应他们在信息需求方面的巨大差异。