Zhang Jie, Yang Dan, Deng Yaotiao, Wang Ying, Deng Lei, Luo Xinmei, Zhong Wuning, Liu Jie, Wang Yuqing, Jiang Yu
Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Chongqing Cancer Institute, 181 Hanyu Road, Shapingba District, Chongqing, China.
Psychooncology. 2015 Dec;24(12):1663-9. doi: 10.1002/pon.3835. Epub 2015 Apr 29.
In China, not only patients and physicians are involved in medical decision-making (MDM) but also the patients' family members. The objective is to investigate the willingness and actual situation of cancer patients and their family members participating in the MDM process.
In this cross-sectional study, questionnaires were administered to 247 pairs of cancer inpatients and their relatives. Information regarding participants' willingness and actual experience during the decision-making process was documented. Eligible participants were cancer inpatients or their relatives, 18 years of age or older, and informed of the cancer diagnosis. All the patients should have received chemotherapy.
The effective response rate was 72.9% (180/247). Over half of the patients (53.3%) and family members (57.8%) were willing to be part of the MDM process. In contrast, only 35.0% of patients and 46.1% of family members actually experienced this process (p = 0.001 and p = 0.011, respectively). Fewer family members (42.2%) than patients (53.3%) believed that patients should be involved in the MDM process (p < 0.001). Patients who were the head of their family (odds ratio 2.577, 95% CI 1.198-5.556, p = 0.015) experienced more involvement in MDM.
Although more than half of Chinese cancer patients and family members wanted to be part of MDM, the actual participation was below their expectation. Majority of family members do not want the patients to be involved in the process of MDM.
在中国,参与医疗决策(MDM)的不仅有患者和医生,还有患者的家庭成员。目的是调查癌症患者及其家庭成员参与MDM过程的意愿和实际情况。
在这项横断面研究中,对247对癌症住院患者及其亲属进行了问卷调查。记录了参与者在决策过程中的意愿和实际经历的信息。符合条件的参与者为18岁及以上的癌症住院患者或其亲属,且已被告知癌症诊断。所有患者均应接受过化疗。
有效回复率为72.9%(180/247)。超过半数的患者(53.3%)和家庭成员(57.8%)愿意参与MDM过程。相比之下,只有35.0%的患者和46.1%的家庭成员实际经历了这个过程(p分别为0.001和0.011)。认为患者应参与MDM过程的家庭成员(42.2%)少于患者(53.3%)(p<0.001)。作为家庭户主的患者参与MDM的程度更高(优势比2.577,95%置信区间1.198 - 5.556,p = 0.015)。
虽然超过半数的中国癌症患者和家庭成员希望参与MDM,但实际参与度低于他们的期望。大多数家庭成员不希望患者参与MDM过程。