Department of Veterans Affairs Medical Center, University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
BJU Int. 2011 Sep;108(6):851-6; discussion 856-7. doi: 10.1111/j.1464-410X.2010.09945.x. Epub 2011 Jan 18.
• To evaluate the degree to which the partners of prostate cancer patients participate in the shared decision-making process with the patients' providers during the time between diagnosis and initiating treatment.
• We recruited patients with newly diagnosed local-stage prostate cancer and their partners to complete take-home surveys after biopsy but before initiating treatment at urology practices in three states. • We asked partners to describe their roles in the decision-making process, including participation in clinic visits, and perceptions of encouragement from providers to participate in the treatment decision-making process. We also asked partners to rate their satisfaction with the patients' providers.
• Family members of 80% of newly diagnosed patients agreed to participate; most (93%) were partners (i.e. spouses or significant others). Most partners (93%) had direct contact with the patients' physicians. • Among the partners who had contact with providers, most (67%) were very satisfied with the patients' providers and 80% indicated that the doctor encouraged them to participate in the treatment decision. Overall, 91% of partners reported very frequent discussions with their loved one about the pending treatment decision, and 69% reported that their role was to help the patient make a decision. • In multivariate models, provider encouragement of partner participation was associated with higher partner satisfaction (odds ratio 3.4, 95% CI 1.4-8.4) and an increased likelihood of partners reporting very frequent discussions with their loved one (odds ratio 6.1, 95% CI 1.3-27.7).
• Partners often attended clinic visits and were very involved in discussions about treatment options with both loved ones and providers. • Provider encouragement of participation by partners greatly facilitates shared decision-making between patients and partners.
评估前列腺癌患者的伴侣在诊断后至开始治疗期间与患者提供者共同参与决策过程的程度。
我们招募了在三个州的泌尿科诊所接受活检但在开始治疗前的新诊断为局部阶段前列腺癌患者及其伴侣，让他们填写家庭作业式调查问卷。我们要求伴侣描述他们在决策过程中的角色，包括参与就诊以及对提供者鼓励他们参与治疗决策过程的看法。我们还要求伴侣对患者提供者的满意度进行评分。
80%的新诊断患者的家属同意参与；大多数（93%）是伴侣（即配偶或重要他人）。大多数（93%）与患者的医生有直接联系。在与提供者有联系的伴侣中，大多数（67%）对患者的提供者非常满意，80%表示医生鼓励他们参与治疗决策。总体而言，91%的伴侣报告与他们所爱的人就即将进行的治疗决策进行了非常频繁的讨论，69%的伴侣报告他们的角色是帮助患者做出决策。在多变量模型中，提供者鼓励伴侣参与与伴侣满意度较高（比值比 3.4，95%CI 1.4-8.4）和伴侣更频繁地与所爱的人讨论（比值比 6.1，95%CI 1.3-27.7）相关。
伴侣经常参加就诊，并非常参与与患者和提供者讨论治疗选择。提供者鼓励伴侣参与极大地促进了患者和伴侣之间的共同决策。
