患有导管原位癌（DCIS）的拉丁裔和非拉丁裔白人对治疗决策的满意度及治疗遗憾情况。
Satisfaction with treatment decision-making and treatment regret among Latinas and non-Latina whites with DCIS.
作者信息
López Mónica E, Kaplan Celia P, Nápoles Anna M, Hwang E Shelley, Livaudais Jennifer C, Karliner Leah S
机构信息
Department of Medicine, University of California San Francisco, San Francisco, USA; Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, San Francisco, USA; Center for Aging in Diverse Communities, University of California San Francisco, San Francisco, USA.
Department of Medicine, University of California San Francisco, San Francisco, USA; Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, San Francisco, USA; Center for Aging in Diverse Communities, University of California San Francisco, San Francisco, USA; UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, USA.
出版信息
Patient Educ Couns. 2014 Jan;94(1):83-9. doi: 10.1016/j.pec.2013.09.005. Epub 2013 Sep 17.
OBJECTIVE
To examine differences in treatment decision-making participation, satisfaction, and regret among Latinas and non-Latina whites with DCIS.
METHODS
Survey of Latina and non-Latina white women diagnosed with DCIS. We assessed women's preferences for involvement in decision-making, primary treatment decision maker, and participatory decision-making. We examined primary outcomes of satisfaction with treatment decision-making and treatment regret by ethnic-language group.
RESULTS
Among 745 participants (349 Latinas, 396 white) Spanish-speaking Latinas (SSL) had the highest mean preference for involvement in decision-making score and the lowest mean participatory decision-making score and were more likely to defer their final treatment decision to their physicians than English-speaking Latinas or whites (26%, 13%, 18%, p<0.05). SSLs reported lower satisfaction with treatment decision-making (OR 0.4; CI 95%, 0.2-0.8) and expressed more regret than whites (OR 6.2; CI 95%, 3.0-12.4). More participatory decision-making increased the odds of satisfaction (OR 1.5; CI 95%, 1.3-1.8) and decreased the odds of treatment regret (OR 0.8; CI 95%, 0.7-1.0), independent of ethnicity-language.
CONCLUSION
Language barriers impede the establishment of decision-making partnerships between Latinas and their physicians, and result in less satisfaction with the decision-making process and more treatment regret.
PRACTICE IMPLICATIONS
Use of professional interpreters may address communication-related disparities for these women.
目的
研究患有导管原位癌（DCIS）的拉丁裔女性和非拉丁裔白人在治疗决策参与度、满意度和遗憾程度方面的差异。
方法
对被诊断为DCIS的拉丁裔和非拉丁裔白人女性进行调查。我们评估了女性对参与决策、主要治疗决策者和参与式决策的偏好。我们按种族语言群体研究了治疗决策满意度和治疗遗憾的主要结果。
结果
在745名参与者中（349名拉丁裔，396名白人），说西班牙语的拉丁裔（SSL）在参与决策得分上的平均偏好最高，参与式决策得分的平均最低，并且比说英语的拉丁裔或白人更有可能将最终治疗决策推迟给医生（26%、13%、18%，p<0.05）。SSL对治疗决策的满意度较低（比值比0.4；95%置信区间，0.2 - 0.8），并且比白人表达了更多的遗憾（比值比6.2；95%置信区间，3.0 - 12.4）。更多的参与式决策增加了满意度的几率（比值比1.5；95%置信区间，1.3 - 1.8），并降低了治疗遗憾的几率（比值比0.8；95%置信区间，0.7 - 1.0），与种族语言无关。
结论
语言障碍阻碍了拉丁裔女性与其医生之间建立决策伙伴关系，并导致对决策过程的满意度较低以及更多的治疗遗憾。
实践意义
使用专业口译员可能解决这些女性与沟通相关的差异。
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