Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
Department of Medicine and Institute of Health Policy, Management, and Evaluation, University Health Network and University of Toronto, Canada.
J Geriatr Oncol. 2018 Jan;9(1):47-52. doi: 10.1016/j.jgo.2017.07.013. Epub 2017 Aug 19.
Little is known about the perspectives of older adults (OAs) with newly-diagnosed cancer on their experiences with cancer treatment decision-making. The objective of this study was to explore the factors that were important for accepting or refusing cancer treatment by older adults undergoing chemotherapy and/or radiation therapy.
A qualitative study using semi-structured interviews with 20 OAs aged ≥65years with newly diagnosed cancer (<6months) receiving either curative or palliative chemotherapy and/or radiation or who had declined therapy. The COREQ reporting guideline was utilized.
The majority of patients accepted the recommended cancer treatment. Most OAs followed their oncologist's recommendation, but spoke of making their own decisions and felt confident about their decisions. Second opinions were not commonly sought. Themes emerged can be divided into two categories: 1) pertaining to cancer treatment decision-making, which includes: "Trust in oncologist", "prolong life", "expected outcomes of treatment", "other people's experience", skeptical about going online" and "assertion of independence", and 2) pertaining to oncologist-patient interactions, which includes "communication".
Older patients largely followed their cancer specialists' treatment recommendations. Most patients were satisfied with their treatment decision and were confident in their decisions. Seeking of second opinions was rare. More needs to be done to address the communication gaps and support needs of this population.
对于新诊断癌症的老年患者（OAs）在癌症治疗决策方面的体验，人们知之甚少。本研究的目的是探讨正在接受化疗和/或放疗的老年癌症患者接受或拒绝癌症治疗的重要因素。
采用半结构式访谈的定性研究方法，对 20 名年龄≥65 岁、新诊断癌症（<6 个月）、接受根治性或姑息性化疗和/或放疗的 OAs 进行研究，或拒绝接受治疗。本研究遵循 COREQ 报告准则。
大多数患者接受了推荐的癌症治疗。大多数 OAs 听从了肿瘤医生的建议，但他们表示自己做了决定，对自己的决定有信心。他们很少寻求第二意见。出现的主题可以分为两类：1）与癌症治疗决策相关，包括：“信任肿瘤医生”、“延长生命”、“治疗预期结果”、“他人的经验”、“对上网持怀疑态度”和“坚持独立性”，以及 2）与肿瘤医生与患者的互动相关，包括“沟通”。
老年患者大多遵循癌症专家的治疗建议。大多数患者对自己的治疗决策感到满意，并对自己的决策充满信心。寻求第二意见的情况很少见。需要做更多的工作来解决这一人群的沟通差距和支持需求。
