Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, ON, Canada.
Support Care Cancer. 2013 Jun;21(6):1717-23. doi: 10.1007/s00520-013-1718-6. Epub 2013 Jan 24.
This study aimed to describe the perceptions of women with early stage breast cancer regarding their involvement in treatment decision making (TDM).
Eligible women with early stage breast cancer were recruited immediately after their first consultation with a specialist. Semistructured personal interviews were held prior to treatment. Interviews were audiotaped, transcribed, and analyzed.
Nineteen women with early stage breast cancer considering surgery (n = 6) or adjuvant therapy (n = 13) participated. Women described being involved in various stages of TDM and interacting with informal networks and specialists. Women's descriptions suggest that (1) the concept of involvement in TDM may have a broader meaning for patients than strictly their decisional role and (2) inclusion of significant others in TDM contributes to the patient's sense of involvement.
Conceptualization and measurement of patient involvement in TDM have often been framed within the context of the medical encounter and the patient's perceived or actual role in this process. Our findings raise questions about what involvement means to patients with early stage breast cancer and suggest that the focus on patient involvement in TDM within the medical encounter may be too narrow to capture the meaning of involvement from the patient's perspective.
本研究旨在描述早期乳腺癌女性对参与治疗决策(TDM)的看法。
在接受专家首次咨询后,立即招募符合条件的早期乳腺癌女性。在治疗前进行半结构化个人访谈。对访谈进行录音、转录和分析。
19 名考虑手术(n=6)或辅助治疗(n=13)的早期乳腺癌女性参与了研究。女性描述了在 TDM 的各个阶段参与并与非正式网络和专家互动。女性的描述表明,(1)参与 TDM 的概念对患者的意义可能比患者在这一过程中的决策角色更广泛;(2)将重要他人纳入 TDM 有助于患者的参与感。
TDM 中患者参与的概念化和测量通常是在医疗接触的背景下和患者在这一过程中的感知或实际角色下进行的。我们的研究结果提出了一个问题,即早期乳腺癌患者的参与意味着什么,并表明在医疗接触中关注患者在 TDM 中的参与可能过于狭隘,无法从患者的角度捕捉参与的意义。