Ruhe Katharina M, Badarau Domnita O, Brazzola Pierluigi, Hengartner Heinz, Elger Bernice S, Wangmo Tenzin
Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
Ospedale Regionale di Bellinzona e Valli-Bellinzona, Pediatria, Bellinzona, Switzerland.
Psychooncology. 2016 Sep;25(9):1036-42. doi: 10.1002/pon.4053. Epub 2015 Dec 17.
The aim of the present study is to explore patient's perspectives in pediatric oncology on participation in discussions and decision-making surrounding their cancer diagnosis.
Seventeen patients between 9 and 17 years of age receiving treatment at centers of the Swiss Pediatric Oncology Group were interviewed for this study. Their interview data was analyzed qualitatively to identify themes with regard to participation in medical communication and/or decision-making.
Participants highlighted how their roles in health care discussions varied from direct participation to indirect involvement. Overall, there were fewer accounts of involvement in decision-making than in overall health care discussions. Challenges with regard to completely understanding the information provided and making decisions were identified. Participants also discussed situations when they were not involved in medical communication or decision-making. While they generally valued their participation, the preferred level of involvement oscillated between participants as well as within one and the same child across time.
The complex pattern of participation found in this study calls for a flexible model of involving children and adolescents in health care that accounts for the varying roles and preferences that they manifest. A patient may appreciate active involvement in some decisions while choosing to remain in the background for others. Copyright © 2015 John Wiley & Sons, Ltd.
本研究旨在探讨儿科肿瘤患者对于参与围绕其癌症诊断的讨论及决策的看法。
本研究对17名年龄在9至17岁之间、正在瑞士儿科肿瘤学组各中心接受治疗的患者进行了访谈。对他们的访谈数据进行了定性分析,以确定在参与医疗沟通和/或决策方面的主题。
参与者强调了他们在医疗保健讨论中的角色从直接参与到间接参与的不同情况。总体而言,参与决策的情况比参与整体医疗保健讨论的情况要少。研究发现了在完全理解所提供的信息及做出决策方面存在的挑战。参与者还讨论了他们未参与医疗沟通或决策的情况。虽然他们总体上重视自己的参与,但不同参与者之间以及同一个孩子在不同时间的参与程度偏好有所波动。
本研究中发现的复杂参与模式需要一个灵活的模式,让儿童和青少年参与医疗保健,该模式要考虑到他们所表现出的不同角色和偏好。患者可能会希望积极参与某些决策,而同时又选择在其他决策中置身事外。版权所有© 2015约翰·威利父子有限公司。