Osaka Wakako, Nakayama Kazuhiro
Department of Nursing Informatics, St. Luke's International University Graduate School of Nursing Science, Tokyo, Japan; School of Nursing, The Jikei University, Tokyo, Japan.
Department of Nursing Informatics, St. Luke's International University Graduate School of Nursing Science, Tokyo, Japan.
Patient Educ Couns. 2017 Mar;100(3):550-562. doi: 10.1016/j.pec.2016.09.011. Epub 2016 Sep 20.
We aimed to evaluate the effect of a decision aid (DA) with patient narratives on decisional conflict in surgery choice for Japanese women with early-stage breast cancer.
Two hundred ten women with early-stage breast cancer were randomly assigned to an intervention or control group. Groups 1 and 2 received standard information and a DA, with or without patient narratives, and Group 3 received standard information (control) before surgery choice. At baseline, post-intervention (Time 2), and 1 month after surgery (Time 3), we evaluated decisional conflict as the primary outcome using a decisional conflict scale (DCS). Sidak corrections for multiple comparisons in analysis of covariate were used to compare Time 2 and Time 3 DCS mean scores between each pair of groups.
At Time 3, decisional conflict was significantly reduced for Group 1 vs control (P=0.021, Cohen's d =0.26) and Group 2 vs control (P=0.008, Cohen's d=0.40).
The DAs with and without patient narratives are equivalently effective at reducing postoperative decisional conflict in Japanese women with early-stage breast cancer.
The DAs with and without patient narratives can be used in clinical practice for women with early-stage breast cancer.
我们旨在评估一种带有患者叙述的决策辅助工具（DA）对日本早期乳腺癌女性手术选择决策冲突的影响。
210名早期乳腺癌女性被随机分配到干预组或对照组。第1组和第2组在手术选择前分别接受标准信息以及带有或不带有患者叙述的DA，第3组接受标准信息（对照组）。在基线、干预后（时间2）以及术后1个月（时间3），我们使用决策冲突量表（DCS）将决策冲突作为主要结局进行评估。在协变量分析中采用Sidak多重比较校正，以比较每组两两之间时间2和时间3的DCS平均得分。
在时间3时，第1组与对照组相比决策冲突显著降低（P = 0.021，Cohen's d = 0.26），第2组与对照组相比决策冲突显著降低（P = 0.008，Cohen's d = 0.40）。
带有和不带有患者叙述的DA在降低日本早期乳腺癌女性术后决策冲突方面效果相当。
带有和不带有患者叙述的DA均可用于早期乳腺癌女性的临床实践。
