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一项离散选择实验,用于评估癌症患者对何时以及如何做出治疗决策的偏好。

A discrete choice experiment to assess cancer patients' preferences for when and how to make treatment decisions.

机构信息

Priority Research Centre for Health Behaviour, Health Behaviour Research Group, University of Newcastle and Hunter Medical Research Institute, W4, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.

School of Psychology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.

出版信息

Support Care Cancer. 2018 Apr;26(4):1215-1220. doi: 10.1007/s00520-017-3944-9. Epub 2017 Oct 31.

Abstract

PURPOSE

Cancer patients can be overwhelmed when being confronted with their diagnosis and treatment options. Such information is often provided during one consultation between the patient and treating clinician. In order to achieve optimal cancer care, there may be justification for alternative consultation styles. We assessed, in a sample of adult medical oncology patients, their preferences for (i) attending one 40-min consultation or two 20-min consultations and (ii) receiving written only or both written and online information, when making a cancer treatment decision.

METHODS

This was a cross-sectional survey using a discrete choice design of 159 adult medical oncology patients presenting for their second or subsequent outpatient consultation. Participants were presented with a set of hypothetical scenarios and asked to indicate their most and least preferred scenario. The scenarios contained a caveat explaining that there would be no difference between the available treatment options in terms of when treatment would be initiated and the impact it would have on patients' life expectancy.

RESULTS

One hundred forty-seven patients completed the DCE. Of these, 70% (n = 103) preferred being provided with written and online information rather than just written information. This preference was statistically significant (p < 0.01). Fifty-nine percent (n = 86) of patients preferred two 20-min consultations over one 40-min consultation when making a treatment decision. Significantly, more patients preferred two shorter consultations rather than one longer consultation when this was combined with written and online information (p < 0.01).

CONCLUSION

When making a cancer treatment decision, clinicians should consider offering patients written and online information, combined with two shorter consultations.

摘要

目的

癌症患者在面对诊断和治疗选择时可能会感到不知所措。这些信息通常在患者和治疗临床医生之间的一次咨询中提供。为了实现最佳的癌症护理,可能有理由采用替代咨询方式。我们在一组成年肿瘤内科患者中评估了他们对以下两种情况的偏好:(i) 参加一次 40 分钟的咨询或两次 20 分钟的咨询,(ii) 在做出癌症治疗决策时,仅接受书面信息或同时接受书面信息和在线信息。

方法

这是一项横断面调查,使用离散选择设计,对 159 名成年肿瘤内科门诊患者进行了调查。参与者被提供了一组假设的情景,并被要求指出他们最偏好和最不偏好的情景。这些情景包含一个警告,即可用的治疗方案在开始治疗的时间和对患者预期寿命的影响方面没有差异。

结果

147 名患者完成了 DCE。其中,70%(n=103)更喜欢提供书面和在线信息,而不仅仅是书面信息。这种偏好具有统计学意义(p<0.01)。59%(n=86)的患者在做出治疗决策时更喜欢两次 20 分钟的咨询,而不是一次 40 分钟的咨询。当将两次较短的咨询与书面和在线信息结合使用时,显著有更多的患者更喜欢两次较短的咨询而不是一次较长的咨询(p<0.01)。

结论

在做出癌症治疗决策时,临床医生应考虑为患者提供书面和在线信息,并结合两次较短的咨询。

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