Klest Bridget, Mutschler Christina, Tamaian Andreea
Department of Psychology, University of Regina, Regina, SK, Canada.
J Clin Nurs. 2016 Sep;25(17-18):2430-7. doi: 10.1111/jocn.13192. Epub 2016 Jun 3.
To explore the factors that affect patient decision-making for an elective surgery.
Cerebral cavernous malformations are lesions found in the brain and spinal cord comprised of abnormal blood vessels, which bleed sporadically causing serious neurological deficits. Course of treatment for cerebral cavernous malformation is often ultimately left up to the patient, and can include symptom management or surgery. Decision-making for surgery in life-threatening conditions has been well documented in the literature. Less extensive research has focused on elective surgeries, where patients have a choice. There has been no research on the factors that affect decision-making for cavernous malformation patients.
Correlational self-report survey.
In part of a larger online study, participants were asked to rate the importance of six factors on their decision-making about surgery for cavernous malformation.
Factors that were rated most important for individuals' decision-making included doctor's opinion regarding surgery, presence of disabling symptoms, fear of symptoms getting worse or developing new symptoms, and availability of an expert surgeon. Results indicated that these were rated as more important than having social support during recovery or having the means to pay for surgery. Additionally, having social support during recovery was rated as significantly more important than having the means to pay for surgery.
Factors that affect decision-making for patients diagnosed with cavernous malformation were similar to those found with other medical conditions requiring elective surgery. This study will assist healthcare workers in understanding the decision-making process of individuals who may choose an elective surgery for potentially disabling conditions with uncertain outcomes.
Understanding the complex factors that affect decision-making in cavernous malformation will assist healthcare professionals to better communicate and support patients in their elective surgery decision-making.
探讨影响患者择期手术决策的因素。
脑海绵状血管畸形是在脑和脊髓中发现的由异常血管组成的病变，这些血管会间歇性出血，导致严重的神经功能缺损。脑海绵状血管畸形的治疗方案通常最终由患者决定，可包括症状管理或手术。关于危及生命情况下手术决策的研究在文献中有充分记载。较少有广泛的研究关注患者有选择余地的择期手术。目前尚无关于影响海绵状血管畸形患者决策因素的研究。
相关性自陈式调查。
在一项更大规模的在线研究中，要求参与者对六个因素在其海绵状血管畸形手术决策中的重要性进行评分。
对个体决策最重要的因素包括医生对手术的意见、存在致残症状、担心症状加重或出现新症状以及是否有专家外科医生。结果表明，这些因素被认为比康复期间有社会支持或有支付手术费用的能力更重要。此外，康复期间有社会支持被认为比有支付手术费用的能力重要得多。
影响被诊断为海绵状血管畸形患者决策的因素与其他需要择期手术的医疗状况中发现的因素相似。本研究将帮助医护人员了解那些可能因潜在致残状况且预后不确定而选择择期手术的个体的决策过程。
了解影响海绵状血管畸形决策的复杂因素将有助于医护专业人员在患者择期手术决策过程中更好地沟通和支持患者。
