Noguera Antonio, Yennurajalingam Sriram, Torres-Vigil Isabel, Parsons Henrique Afonseca, Duarte Eva Rosina, Palma Alejandra, Bunge Sofia, Palmer J Lynn, Bruera Eduardo
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Hospital Centro de Cuidados Laguna, Madrid, Spain.
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
J Pain Symptom Manage. 2014 May;47(5):896-905. doi: 10.1016/j.jpainsymman.2013.06.010. Epub 2013 Sep 12.
Studies to determine the decisional control preferences (DCPs) in Hispanic patients receiving palliative care are limited.
The aims of this study were to describe DCPs, disclosure of information, and satisfaction with decision making among Hispanics and to determine the degree of concordance between patients' DCPs and their self-reported decisions.
We surveyed 387 cancer patients referred to outpatient palliative care clinics in Argentina, Chile, Guatemala, and the U.S. DCPs were measured with the Control Preference Scale, disclosure preferences with the Disclosure of Information Preferences questionnaire, and satisfaction with care with the Satisfaction with Decision Scale.
In this study, 182 patients (47.6%) preferred shared decisional control, 119 (31.2%) preferred active decisional control, and 81 (21.2%) preferred a passive approach. Concerning their diagnosis and prognosis, 345 (92%) patients wanted to know their diagnosis, and 355 (94%) wanted to know their prognosis. Three hundred thirty-seven (87%) patients were satisfied with the decision-making process. DCPs were concordant with the self-reported decision-making process in 264 (69%) patients (weighted kappa = 0.55). Patients' greater satisfaction with the decision-making process was correlated with older age (P ≤ 0.001) and with a preference for enhanced diagnostic disclosure (P ≤ 0.024). Satisfaction did not correlate with concordance in the decision-making process.
The vast majority preferred a shared or active decision-making process and wanted information about their diagnosis and prognosis. Older patients and those who wanted to know their diagnosis seemed to be more satisfied with the way treatment decisions were made.
关于确定接受姑息治疗的西班牙裔患者的决策控制偏好（DCP）的研究有限。
本研究的目的是描述西班牙裔患者的决策控制偏好、信息披露情况以及对决策的满意度，并确定患者的决策控制偏好与其自我报告的决策之间的一致程度。
我们对阿根廷、智利、危地马拉和美国门诊姑息治疗诊所转诊的387名癌症患者进行了调查。使用控制偏好量表测量决策控制偏好，使用信息披露偏好问卷测量信息披露偏好，使用决策满意度量表测量对护理的满意度。
在本研究中，182名患者（47.6%）倾向于共同决策控制，119名（31.2%）倾向于积极决策控制，81名（21.2%）倾向于被动决策方式。关于他们的诊断和预后，345名（92%）患者想知道自己的诊断，355名（94%）想知道自己的预后。337名（87%）患者对决策过程感到满意。264名（69%）患者的决策控制偏好与自我报告的决策过程一致（加权kappa = 0.55）。患者对决策过程更高的满意度与年龄较大（P≤0.001）以及对增强诊断信息披露的偏好（P≤0.024）相关。满意度与决策过程中的一致性无关。
绝大多数患者倾向于共同或积极的决策过程，并希望了解有关他们诊断和预后的信息。老年患者和那些想知道自己诊断的患者似乎对治疗决策的方式更满意。
