Cardenas Jhosselini, Infante Pamela, Infante Abel, Chuang Elizabeth, Selwyn Peter
Department of Family and Social Medicine, Palliative Care Service, Montefiore Medical Center, 3347 Steuben Ave, 2nd Floor, Bronx, NY, 10467, USA.
Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY, USA.
J Cancer Educ. 2019 Jun;34(3):472-477. doi: 10.1007/s13187-018-1325-9.
Hispanic Americans are among the fastest growing minority groups in the USA, and understanding their preferences for medical decision-making and information sharing is imperative to provide high quality end of life care. Studies exploring these decision control preferences (DCPs) are limited and found inconsistent results. (1) To measure DCPs of Hispanic patients in the Bronx. (2) To measure disclosure of information preferences of Hispanic patients in the Bronx. This is a cross-sectional survey. One hundred nineteen cancer patients who self-identified as Hispanic and were waiting at the oncology clinic at Montefiore Medical Center Cancer Center. Proportions of patients endorsing DCPs and disclosure of information preferences are reported. The relationship between patient characteristics and DCPs was tested using chi-squared tests of homogeneity. The majority (63, 52.9%) preferred shared decision-making with their doctors, families or both, while 46 (38.7%) had an active decision-making style. A minority (9, 7.6%) had a passive decision-making style, deferring to their families, and only 1 (0.8%) deferring to the physician. No demographic characteristics significantly predicted DCPs. The majority of patients agreed or strongly agreed that they wanted to hear all of the information regarding their diagnosis (94%), treatment options (94%), treatment expectations (92%), and treatment risks and benefits (96%). These results confirm our hypothesis that most Hispanic patients prefer either an active or shared decision-making process rather than a passive decision-making process. Most patients prefer disclosure of diagnosis, prognosis, and plan.
西班牙裔美国人是美国增长最快的少数族裔群体之一，了解他们在医疗决策和信息共享方面的偏好对于提供高质量的临终关怀至关重要。探索这些决策控制偏好（DCPs）的研究有限且结果不一致。（1）测量布朗克斯区西班牙裔患者的决策控制偏好。（2）测量布朗克斯区西班牙裔患者的信息披露偏好。这是一项横断面调查。119名自我认定为西班牙裔且在蒙特菲奥里医疗中心癌症中心肿瘤门诊候诊的癌症患者。报告了认可决策控制偏好和信息披露偏好的患者比例。使用卡方同质性检验来检验患者特征与决策控制偏好之间的关系。大多数（63人，52.9%）倾向于与医生、家人或双方共同决策，而46人（38.7%）具有积极决策风格。少数（9人，7.6%）具有被动决策风格，听从家人意见，只有1人（0.8%）听从医生意见。没有人口统计学特征能显著预测决策控制偏好。大多数患者同意或强烈同意他们想了解所有关于自己诊断（94%）、治疗选择（94%）、治疗期望（92%）以及治疗风险和益处（96%）的信息。这些结果证实了我们的假设，即大多数西班牙裔患者更喜欢积极或共同决策过程而非被动决策过程。大多数患者希望了解诊断、预后和治疗计划。
