Lam William Wing-Kuen, Loke Alice Yuen
The University of Hong Kong, School of Nursing, Hong Kong.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
Int J Orthop Trauma Nurs. 2017 May;25:11-18. doi: 10.1016/j.ijotn.2016.09.001. Epub 2016 Sep 13.
A literature review.
To identify the factors and concerns that influence the decision of patients to undergo spinal surgery.
Electronic databases MEDLINE, PsycINFO, CINAHL plus, and Embase were searched for relevant studies published from 2000 to 2015. The keywords for the search included: spine surgery OR spinal stenosis AND decision making OR consideration OR preference OR willingness OR concern. Seven quantitative studies met the criteria for inclusion and were included in this review.
The findings showed that patients were more likely to decide on surgery when they were suffering from severe bodily pain, poor physical function, poor psychosocial health and a higher level of functional disability. Concerns that affected the patients' decision on whether or not to opt for surgery were: the benefits weighed against the perceived risks of different modalities of treatment, the effectiveness of medical treatments, their level of satisfaction with their symptoms and a preference for autonomy or a reliance on the opinion of medical professionals. The findings relating to patient characteristics and preference for surgery were inconsistent.
Patients go through a complex and a multi-factorial process in making the decision whether or not to undergo surgery, which calls for decision support interventions that will help them to make the decision.
文献综述。
确定影响患者决定接受脊柱手术的因素和关注点。
检索电子数据库MEDLINE、PsycINFO、CINAHL plus和Embase，查找2000年至2015年发表的相关研究。检索关键词包括：脊柱手术或椎管狭窄以及决策或考虑因素或偏好或意愿或关注点。七项定量研究符合纳入标准并被纳入本综述。
研究结果表明，当患者遭受严重身体疼痛、身体功能差、心理社会健康状况不佳以及功能残疾程度较高时，他们更有可能决定接受手术。影响患者决定是否选择手术的关注点包括：不同治疗方式的益处与感知风险的权衡、医疗治疗的有效性、他们对症状的满意度以及对自主性的偏好或对医疗专业人员意见的依赖。与患者特征和手术偏好相关的研究结果不一致。
患者在决定是否接受手术时经历了一个复杂的多因素过程，这需要决策支持干预措施来帮助他们做出决定。
