Department of Internal Medicine, The Lung Cancer Diagnostic Organization, Lillebaelt Hospital, Vejle, Denmark.
Department of Internal Medicine, Lillebaelt Hospital, Kolding, Denmark.
Patient Educ Couns. 2019 Nov;102(11):1961-1968. doi: 10.1016/j.pec.2019.05.018. Epub 2019 May 16.
The objective of this study was to describe the impact on patient-reported outcomes of introducing Shared Decision Making (SDM) and a Patient Decision Aid (PtDA) in the initial process of lung cancer diagnostics.
We conducted a prospective cohort study, where a control cohort was consulted according to usual clinical practice. After introducing SDM through a PtDA and training of the staff, the SDM cohort was enrolled in the study. All patients completed four questionnaires: the Decisional Conflict Scale (DCS) before and after the consultation, the CollaboRATE scale after the consultation, and the Decision Regret Scale (DRS).
Patients exposed to SDM and a PtDA had significantly improved DCS scores after the consultation compared to the control group (a difference of 10.26, p = 0.0128) and significantly lower DRS scores (a difference of 8.98, p = 0.0197). Of the 82 control patients and 52 SDM patients 29% and 54%, respectively, gave the maximum score on the CollaboRATE scale (Pearson's chi 8.0946, p = 0.004).
The use of SDM and a PtDA had significant positive impact on patient-reported outcomes.
Our results may encourage the increased uptake of SDM in the initial process of lung cancer diagnostics.
本研究旨在描述在肺癌诊断初始阶段引入共享决策(SDM)和患者决策辅助工具(PtDA)对患者报告结局的影响。
我们进行了一项前瞻性队列研究,其中对照队列按照常规临床实践进行咨询。在通过 PtDA 引入 SDM 并对员工进行培训后,将 SDM 队列纳入研究。所有患者完成了四个问卷:咨询前后的决策冲突量表(DCS)、咨询后的 CollaboRATE 量表和决策后悔量表(DRS)。
与对照组相比,接受 SDM 和 PtDA 的患者在咨询后 DCS 评分显著提高(差异为 10.26,p=0.0128),DRS 评分显著降低(差异为 8.98,p=0.0197)。在 82 名对照患者和 52 名 SDM 患者中,分别有 29%和 54%的患者在 CollaboRATE 量表上获得了最高分(Pearson's chi 8.0946,p=0.004)。
SDM 和 PtDA 的使用对患者报告结局产生了显著的积极影响。
我们的结果可能鼓励在肺癌诊断的初始阶段增加 SDM 的使用。