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在早期乳腺癌的治疗中,面临手术和原发性内分泌治疗选择的老年女性的信息需求和决策偏好。

Information needs and decision-making preferences of older women offered a choice between surgery and primary endocrine therapy for early breast cancer.

作者信息

Burton Maria, Kilner Karen, Wyld Lynda, Lifford Kate Joanna, Gordon Frances, Allison Annabel, Reed Malcolm, Collins Karen Anna

机构信息

Centre for Health and Social Care Research, Sheffield Hallam University, Collegiate Crescent, Sheffield, UK.

Academic Unit of Surgical Oncology, University of Sheffield, Medical School, Sheffield, UK.

出版信息

Psychooncology. 2017 Dec;26(12):2094-2100. doi: 10.1002/pon.4429. Epub 2017 Apr 17.

Abstract

OBJECTIVES

To establish older women's (≥75 years) information preferences regarding 2 breast cancer treatment options: surgery plus adjuvant endocrine therapy versus primary endocrine therapy. To quantify women's preferences for the mode of information presentation and decision-making (DM) style.

METHODS

This was a UK multicentre survey of women, ≥75 years, who had been offered a choice between PET and surgery at diagnosis of breast cancer. A questionnaire was developed including 2 validated scales of decision regret and DM preferences.

RESULTS

Questionnaires were sent to 247 women, and 101 were returned (response rate 41%). The median age of participants was 82 (range 75 to 99), with 58 having had surgery and 37 having PET. Practical details about the impact, safety, and efficacy of treatment were of most interest to participants. Of least interest were cosmetic outcomes after surgery. Information provided verbally by doctors and nurses, supported by booklets, was preferred. There was little interest in technology-based sources of information. There was equal preference for a patient- or doctor-centred DM style and lower preference for a shared DM style. The majority (74%) experienced their preferred DM style. Levels of decision regret were low (15.73, scale 0-100).

CONCLUSIONS

Women strongly preferred face to face information. Written formats were also helpful but not computer-based resources. Information that was found helpful to women in the DM process was identified. The study demonstrates many women achieved their preferred DM style, with a preference for involvement, and expressed low levels of decision regret.

摘要

目的

确定老年女性(≥75岁)对于两种乳腺癌治疗方案的信息偏好:手术加辅助内分泌治疗与原发性内分泌治疗。量化女性对信息呈现方式和决策方式的偏好。

方法

这是一项在英国多中心针对年龄≥75岁、在乳腺癌诊断时被提供原发性内分泌治疗和手术选择的女性进行的调查。设计了一份问卷,其中包括两个经过验证的决策遗憾量表和决策偏好量表。

结果

向247名女性发送了问卷,101份问卷被收回(回复率41%)。参与者的年龄中位数为82岁(范围75至99岁),其中58人接受了手术,37人接受了原发性内分泌治疗。参与者最感兴趣的是治疗的影响、安全性和疗效方面的实际细节。最不感兴趣的是手术后的美容效果。参与者更喜欢医生和护士口头提供并辅以手册的信息。对基于技术的信息来源兴趣不大。对于以患者为中心或以医生为中心的决策方式有同等偏好,而对于共同决策方式的偏好较低。大多数人(74%)体验到了她们偏好的决策方式。决策遗憾水平较低(量表0 - 100,为15.73)。

结论

女性强烈偏好面对面的信息。书面形式也有帮助,但不是基于计算机的资源。确定了在决策过程中对女性有帮助的信息。该研究表明,许多女性实现了她们偏好的决策方式,倾向于参与其中,并且表达的决策遗憾水平较低。

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