Tanno Kiyomi, Bito Seiji
Division of Clinical Epidemiology, National Hospital Organization, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8602, Japan.
J Patient Rep Outcomes. 2019 Jul 17;3(1):43. doi: 10.1186/s41687-019-0137-y.
To ensure that patients continue treatment, it is essential that the patient is satisfied with the decision-making process of the treatment. One way to address this is to assess the healthcare quality using the concept of regret, which can measure "Being convinced in decision-making." This study aimed to elucidate patient factors affecting regret using the Japanese version of the Decision Regret Scale (DRS).
A questionnaire survey was conducted with 197 patients with uterine myoma, ovarian tumors, and endometriosis. We then examined the relationship between the Japanese DRS, the Japanese SF-8 as a health-related quality of life (QOL), and patient factors using latent class analysis and path analysis through a multi-group comparison.
The final sample comprised 102 patients. Patients were classified into the following two groups based on the latent class analysis of patient characteristics: many patients who were married and had children and a few patients who were unmarried and had no children (class 1), and many patients who were unmarried and had no children and a few patients who were married and had children (class 2). The path analysis through the group comparison of the two classes revealed that subjective symptoms, preferences, and surgical procedure (laparotomy or laparoscopic surgery) had a direct impact on regret. The magnitude of the influence factors for Class 1 and Class 2 Regret was different. The indirect effect on regret was through mental component summary.
Our results suggest that it is necessary to present treatment methods with consideration to patients' backgrounds and to obtain informed consent from patients.
为确保患者持续接受治疗，患者对治疗决策过程感到满意至关重要。解决这一问题的一种方法是使用遗憾的概念来评估医疗质量，遗憾可以衡量“在决策中被说服的程度”。本研究旨在使用日语版决策遗憾量表（DRS）阐明影响遗憾的患者因素。
对197例子宫肌瘤、卵巢肿瘤和子宫内膜异位症患者进行问卷调查。然后，我们通过多组比较，使用潜在类别分析和路径分析，研究了日语版DRS、作为健康相关生活质量（QOL）的日语版SF-8与患者因素之间的关系。
最终样本包括102例患者。根据患者特征的潜在类别分析，患者被分为以下两组：许多已婚并有子女的患者和少数未婚且无子女的患者（第1类），以及许多未婚且无子女的患者和少数已婚并有子女的患者（第2类）。通过对这两类进行组间比较的路径分析表明，主观症状、偏好和手术方式（剖腹手术或腹腔镜手术）对遗憾有直接影响。第1类和第2类遗憾的影响因素大小不同。对遗憾的间接影响是通过心理成分总结产生的。
我们的结果表明，有必要根据患者背景提供治疗方法，并获得患者的知情同意。
