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基于理论的癌症患者决策辅助工具:DecisionKEYS for cancer 的可行性和可接受性测试结果。

A theory-based decision aid for patients with cancer: results of feasibility and acceptability testing of DecisionKEYS for cancer.

机构信息

University of Virginia, Charlottesville, VA 22903-3387, USA.

出版信息

Support Care Cancer. 2013 Mar;21(3):889-99. doi: 10.1007/s00520-012-1603-8. Epub 2012 Oct 11.

Abstract

PURPOSE

Appropriate utilization of treatment is a goal for all patients undergoing cancer treatment. Proper treatment maximizes benefit and limits exposure to unnecessary measures. This report describes findings of the feasibility and acceptability of implementing a short, clinic-based decision aid and presents an in-depth clinical profile of the participants.

METHODS

This descriptive study used a prospective, quantitative approach to obtain the feasibility and acceptability of a decision aid (DecisionKEYS for Balancing Choices) for use in clinical settings. It combined results of trials of patients with three different common malignancies. All groups used the same decision aid series. Participants included 80 patients with solid tumors (22 with newly diagnosed breast cancer, 19 with advanced prostate cancer, and 39 with advanced lung cancer) and their 80 supporters as well as their physicians and nurses, for a total of 160 participants and 10 health professionals.

RESULTS

The decision aid was highly acceptable to patient and supporter participants in all diagnostic groups. It was feasible for use in clinic settings; the overall value was rated highly. Of six physicians, all found the interactive format with the help of the nurse as feasible and acceptable. Nurses also rated the decision aid favorably.

CONCLUSIONS

This intervention provides the opportunity to enhance decision making about cancer treatment and warrants further study including larger and more diverse groups. Strengths of the study included a theoretical grounding, feasibility testing of a practical clinic-based intervention, and summative evaluation of acceptability of the intervention by patient and supporter pairs. Further research also is needed to test the effectiveness of the decision aid in diverse clinical settings and to determine if this intervention can decrease overall costs.

摘要

目的

使所有接受癌症治疗的患者得到适当的治疗是一个目标。适当的治疗可以最大限度地提高效益,并限制不必要的措施。本报告描述了实施基于诊所的简短决策辅助工具的可行性和可接受性的发现,并介绍了参与者的深入临床概况。

方法

本描述性研究采用前瞻性、定量方法,以获得在临床环境中使用决策辅助工具(DecisionKEYS for Balancing Choices)的可行性和可接受性。它结合了三种不同常见恶性肿瘤患者的试验结果。所有组都使用相同的决策辅助系列。参与者包括 80 名实体瘤患者(22 名新诊断为乳腺癌,19 名晚期前列腺癌,39 名晚期肺癌)及其 80 名支持者以及他们的医生和护士,总共有 160 名参与者和 10 名卫生专业人员。

结果

在所有诊断组中,决策辅助工具都非常受患者和支持者的欢迎。它在诊所环境中使用是可行的;整体价值评价很高。在六名医生中,所有医生都认为与护士一起使用互动格式是可行和可接受的。护士也对决策辅助工具评价良好。

结论

这种干预措施为增强对癌症治疗的决策提供了机会,值得进一步研究,包括更大和更多样化的群体。该研究的优势包括理论基础、对基于诊所的实际干预措施的可行性测试以及对患者和支持者对干预措施的可接受性的总结性评估。还需要进一步研究来测试该决策辅助工具在不同临床环境中的有效性,并确定该干预措施是否可以降低总体成本。

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