Chien Ching-Hui, Chuang Cheng-Keng, Liu Kuan-Lin, Li Chia-Lin, Liu Hsueh-Erh
College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
J Clin Nurs. 2014 Jul;23(13-14):1959-69. doi: 10.1111/jocn.12470. Epub 2013 Dec 20.
To identify the changes and associated factors in decisional conflict and regret in patients with localised prostate cancer up to six months postprimary treatment.
Various treatments of differing qualities can be used for patients with localised prostate cancer; these treatments may cause conflicts in treatment decision-making and post-treatment regret.
A quantitative longitudinal study.
A total of 48 patients were recruited from a 3700-bed medical centre in northern Taiwan and assessed at pretreatment and one and six months post-treatment. Demographic characteristics, clinical information and results from the psychosocial adjustment to illness scale, decisional conflict scale and decision regret scale were collected. Data were analysed based on the generalised estimating equations models.
The overall decisional conflict substantially improved over time. However, the feeling of being less informed was high and did not improve considerably during the study period. Education level, decision preferences and psychosocial adjustment were associated with decisional conflict and influenced decision-making. The feeling of ineffective decision-making and decisional regret was low, post-treatment. Psychosocial adjustment was associated with effective decision-making and decisional regret.
In patients with localised prostate cancer, decisional conflict reduced considerably up to six months post-treatment. Moreover, the patients were satisfied with their treatment decision-making and believed that they had made the correct choice up to six months post-treatment. However, patients may have experienced feelings of being less informed pre- and post-treatment, particularly those with lower education levels, a preference for passive roles, or inferior psychosocial adjustment. Consequently, health professionals must provide adequate medical information and psychosocial intervention to help patients in the decision-making process.
Nurses and healthcare providers must provide localised prostate cancer patients with adequate information and psychosocial intervention to reduce decisional conflict.
确定局限性前列腺癌患者在初次治疗后长达六个月内决策冲突和遗憾的变化及相关因素。
局限性前列腺癌患者可采用多种质量不同的治疗方法；这些治疗可能会在治疗决策和治疗后遗憾方面引发冲突。
一项定量纵向研究。
从台湾北部一家拥有3700张床位的医疗中心招募了48名患者，并在治疗前、治疗后1个月和6个月进行评估。收集人口统计学特征、临床信息以及疾病心理社会适应量表、决策冲突量表和决策遗憾量表的结果。基于广义估计方程模型对数据进行分析。
总体决策冲突随时间显著改善。然而，信息不足的感觉较高，且在研究期间没有明显改善。教育水平、决策偏好和心理社会适应与决策冲突相关，并影响决策。治疗后无效决策感和决策遗憾感较低。心理社会适应与有效决策和决策遗憾相关。
在局限性前列腺癌患者中，治疗后长达六个月决策冲突显著减少。此外，患者对其治疗决策感到满意，并认为在治疗后长达六个月内他们做出了正确的选择。然而，患者在治疗前后可能会有信息不足的感觉，尤其是那些教育水平较低、偏好被动角色或心理社会适应较差的患者。因此，医护人员必须提供充分的医疗信息和心理社会干预，以帮助患者进行决策。
护士和医疗服务提供者必须为局限性前列腺癌患者提供充分的信息和心理社会干预，以减少决策冲突。
