Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Patient & Caregiver Education, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
J Pain Symptom Manage. 2019 Dec;58(6):1048-1055.e2. doi: 10.1016/j.jpainsymman.2019.08.014. Epub 2019 Aug 28.
Advanced cancer patients have unrecognized gaps in their understanding about palliative radiation therapy (PRT).
To build a video decision aid for hospitalized patients with advanced cancer referred for PRT and prospectively test its efficacy in reducing decisional uncertainty, improving knowledge, increasing treatment readiness and readiness for palliative care consultation, and its acceptability among patients.
Forty patients with advanced cancer hospitalized at Memorial Sloan Kettering Cancer Center watched a video decision aid about PRT and palliative care. Patients' conceptual and logistical knowledge of PRT, decisional uncertainty, treatment readiness, and readiness for palliative care consultation were assessed before and after watching the video with a six-item knowledge survey, the decisional uncertainty subscale of the Decisional Conflict Scale, and Likert instruments to assess readiness to accept radiation treatment and/or palliative care consultation, respectively. A postvideo survey assessed the video's acceptability among patients.
After watching the video, decisional uncertainty was reduced (28.3 vs. 21.7; P = 0.02), knowledge of PRT improved (60.4 vs. 88.3; P < 0.001), and PRT readiness increased (2.0 vs. 1.3; P = 0.04). Readiness for palliative care consultation was unchanged (P = 0.58). Patients felt very comfortable (70%) watching the video and would highly recommend it (75%) to others.
Among hospitalized patients with advanced cancer, a video decision aid reduced decisional uncertainty, improved knowledge of PRT, increased readiness for PRT, and was well received by patient viewers.
晚期癌症患者对姑息性放射治疗（PRT）的理解存在未被认识到的差距。
为因 PRT 而住院的晚期癌症患者制作视频决策辅助工具，并前瞻性地检验其在降低决策不确定性、提高知识、增加治疗准备和姑息治疗咨询准备方面的效果，以及患者对其的接受程度。
在纪念斯隆凯特琳癌症中心住院的 40 名晚期癌症患者观看了关于 PRT 和姑息治疗的视频决策辅助工具。通过六项知识调查、决策冲突量表的决策不确定性子量表以及评估接受放射治疗和/或姑息治疗咨询意愿的李克特量表，分别在观看视频前后评估患者对 PRT 的概念和逻辑知识、决策不确定性、治疗准备和姑息治疗咨询准备情况。视频后调查评估了患者对视频的接受程度。
观看视频后，决策不确定性降低（28.3 分比 21.7 分；P=0.02），PRT 知识提高（60.4 分比 88.3 分；P<0.001），PRT 准备度增加（2.0 分比 1.3 分；P=0.04）。对姑息治疗咨询的准备情况没有变化（P=0.58）。患者观看视频非常舒适（70%），并会强烈推荐给他人（75%）。
在因晚期癌症住院的患者中，视频决策辅助工具降低了决策不确定性，提高了对 PRT 的了解，增加了对 PRT 的准备，并受到患者观看者的好评。
