Tariman Joseph D, Doorenbos Ardith, Schepp Karen G, Singhal Seema, Berry Donna L
Division of Hematology and Oncology, Northwestern University Medical Faculty Foundation, Chicago, IL.
School of Nursing, University of Washington in Seattle.
Oncol Nurs Forum. 2014 Jul 1;41(4):411-9. doi: 10.1188/14.ONF.411-419.
PURPOSE/OBJECTIVES: To describe the preferences for participation in decision making of older adult patients newly diagnosed with symptomatic myeloma and to explore the association between sociodemographic variables and decisional role preferences.
Descriptive, cross-sectional design.
Participants' homes and two large academic cancer centers in Seattle, WA, and Chicago, IL.
A convenience sample of 20 older adults (60 years of age and older) with symptomatic myeloma diagnosed within the past six months.
The Control Preferences Scale was administered followed by an in-person, one-time, semistructured interview.
Role preferences for participation in treatment decision making, age, gender, race, work status, personal relationship status, education, and income.
Fifty-five percent of the participants preferred a shared role with the physician and 40% preferred to make the decisions after seriously considering the opinion of their physicians. Only one participant preferred to leave the decision to the doctor, as long as the doctor considered the patient's treatment preferences.
The study findings indicate that older adults newly diagnosed with myeloma want to participate in treatment decision making. Oncology nurses must respect the patient's desired role preference and oncology clinicians must listen to the patient and allow him or her to be autonomous in making treatment decisions.
Nurses and other oncology clinicians can elicit a patient's preferred level of participation in treatment decision making. Oncology nurses can make sure patients receive disease- and treatment-related information, encourage them to express their decisional role preference to the physician, develop a culture of mutual respect and value their desire for autonomy for treatment decision making, acknowledge that the right to make a treatment choice belongs to the patient, and provide support during treatment decision making throughout the care continuum.
目的/目标：描述新诊断出有症状骨髓瘤的老年患者对参与决策的偏好，并探讨社会人口统计学变量与决策角色偏好之间的关联。
描述性横断面设计。
参与者家中以及华盛顿州西雅图市和伊利诺伊州芝加哥市的两家大型学术癌症中心。
从过去六个月内新诊断出有症状骨髓瘤的20名老年人（60岁及以上）中选取的便利样本。
使用控制偏好量表，随后进行一次面对面的半结构化访谈。
参与治疗决策的角色偏好、年龄、性别、种族、工作状态、个人关系状况、教育程度和收入。
55%的参与者倾向于与医生共同决策，40%的参与者倾向于在认真考虑医生意见后做出决策。只有一名参与者倾向于将决策留给医生，只要医生考虑患者的治疗偏好。
研究结果表明，新诊断出骨髓瘤的老年人希望参与治疗决策。肿瘤护理人员必须尊重患者期望的角色偏好，肿瘤临床医生必须倾听患者意见并允许其在治疗决策中自主决定。
护士和其他肿瘤临床医生可以了解患者在治疗决策中期望的参与程度。肿瘤护理人员可以确保患者获得疾病和治疗相关信息，鼓励他们向医生表达自己的决策角色偏好，营造相互尊重的文化氛围，重视他们在治疗决策中的自主愿望，承认治疗选择的权利属于患者，并在整个护理过程中的治疗决策期间提供支持。
