Elit Laurie, Charles Cathy A, Gafni Amiram
Departments of *Obstetrics and Gynecology and †Clinical Epidemiology and Biostatistics and ‡Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
Int J Gynecol Cancer. 2015 Nov;25(9):1717-23. doi: 10.1097/IGC.0000000000000548.
The treatment decision-making (TDM) process in the medical encounter in ovarian cancer (OC) is directed by oncologists. There is little information on oncologists' perceptions of this process. Our objectives were to explore oncologists' perceptions concerning (1) patients' preference for involvement in TDM, (2) factors that affect when to introduce this discussion, and (3) strategies used for engaging women in TDM.
We adopted a qualitative descriptive approach. Individual in-person interviews were used to collect data; themes were identified.
Fifteen gynecologic and 5 medical oncologists from Ontario, Canada, participated. We found that oncologists made the assumption that women with recurrent OC were interested in being involved in TDM but rarely reported attempting to validate this assumption. The oncologists timed the initiation of the TDM discussion based on their degree of certainty of recurrent OC and their perception of the patient's readiness to be involved in TDM. Oncologists reported using strategies to engage women such as getting the women to take ownership of the decision, verbalize their priorities, lead the discussions, and giving the opportunity to gather information.
Oncologists need to listen to each patient rather than make assumptions about the person based on her disease.
卵巢癌（OC）医疗会诊中的治疗决策制定（TDM）过程由肿瘤学家主导。关于肿瘤学家对这一过程的看法，相关信息较少。我们的目的是探讨肿瘤学家对以下方面的看法：（1）患者参与TDM的偏好；（2）影响何时引入该讨论的因素；（3）促使女性参与TDM所采用的策略。
我们采用定性描述性方法。通过个人面对面访谈收集数据；确定主题。
来自加拿大安大略省的15名妇科肿瘤学家和5名医学肿瘤学家参与了研究。我们发现，肿瘤学家认为复发性OC女性有兴趣参与TDM，但很少报告尝试验证这一假设。肿瘤学家根据对复发性OC的确定程度以及对患者参与TDM准备情况的认知来确定TDM讨论的起始时间。肿瘤学家报告说，他们采用了一些策略来促使女性参与，比如让女性对决策负责、说出自己的优先事项、主导讨论以及提供收集信息的机会。
肿瘤学家需要倾听每位患者的意见，而不是基于患者的疾病对其进行假设。
