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约旦医生对患者参与治疗决策的感知障碍与促进因素:一项探索性研究。

Jordanian physicians' perceived barriers and facilitators to patient participation in treatment decision-making: An exploratory study.

作者信息

Obeidat Rana F, Lally Robin M

机构信息

Adult Health Nursing, Faculty of Nursing, Zarqa University, Zarqa, Jordan.

College of Nursing, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Nebraska Medical Center, Nebraska, USA.

出版信息

Indian J Cancer. 2018 Oct-Dec;55(4):377-381. doi: 10.4103/ijc.IJC_122_18.

Abstract

BACKGROUND

Successful implementation of shared decision-making in clinical encounters is influenced by system, patient, and clinician factors that both facilitate and present barriers to patient-centered care. Little is known about which factors Jordanian physicians believe influence their ability to implement shared decision-making with cancer patients.

AIMS

To determine Jordanian physicians' perceived barriers and facilitators to patient participation in treatment decision-making.

SETTINGS AND DESIGN

A cross-sectional exploratory survey design was used in the study. A convenience sample of 86 Jordanian medical and radiation oncologists and surgeons was recruited.

MATERIALS AND METHODS

A valid measure of physicians' views of shared decision-making was slightly modified from its original English and used to collect data. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) for windows version 19.0 (SPSS, Inc., Chicago, IL, USA). Descriptive and inferential statistics were carried as appropriate.

RESULTS

Insufficient time to spend with the patient, patient expecting a certain treatment rather than a consultation, and the patient's family overriding the decision-making process were the most frequently reported barriers to patient participation in treatment decision-making. Physicians believed that patients trust in physicians and patient being accompanied at the consultation were important facilitators of patient participation in treatment decision-making.

CONCLUSIONS

Jordanian physicians perceive multiple barriers to patient participation in treatment decision-making. Patient-related difficulties (e.g., indecision), and system-related difficulties, in particular, patient's family influence on the decision-making process are more prevalent among Jordanian physicians compared to Western physicians.

摘要

背景

临床诊疗中共同决策的成功实施受到多种因素的影响,包括系统、患者和临床医生等因素,这些因素既有助于以患者为中心的医疗服务,也存在阻碍。对于约旦医生认为哪些因素会影响他们与癌症患者实施共同决策的能力,我们知之甚少。

目的

确定约旦医生对患者参与治疗决策的感知障碍和促进因素。

设置与设计

本研究采用横断面探索性调查设计。招募了86名约旦医学肿瘤学家、放射肿瘤学家和外科医生作为便利样本。

材料与方法

对一份衡量医生对共同决策看法的有效量表在其原始英文版本基础上进行了轻微修改,并用于收集数据。使用适用于Windows版本19.0的社会科学统计软件包(SPSS,美国伊利诺伊州芝加哥市SPSS公司)对数据进行分析。酌情进行描述性和推断性统计。

结果

与患者相处时间不足、患者期望某种特定治疗而非咨询以及患者家属凌驾于决策过程之上,是最常被报告的患者参与治疗决策的障碍。医生认为患者对医生的信任以及患者在咨询时有陪同是患者参与治疗决策的重要促进因素。

结论

约旦医生察觉到患者参与治疗决策存在多种障碍。与西方医生相比,与患者相关的困难(例如犹豫不决)以及与系统相关的困难,特别是患者家属对决策过程的影响,在约旦医生中更为普遍。

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