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[医生对肿瘤学实践中共同决策的认识与评估。]

[Physicians' awareness and assessment of shared decision making in oncology practice.].

作者信息

Padilla Garrido Nuria, Aguado Correa Francisco, Bayo Lozano Eloísa, Bayo Calero Juan, Ortega Moreno Mónica

机构信息

Departamento de Métodos Cuantitativos para la Economía y la Empresa, Estadística e Investigación Operativa. Universidad de Huelva. Huelva. España.

Departamento de Economía Financiera, Contabilidad y Dirección de Operaciones. Universidad de Huelva. Huelva. España.

出版信息

Rev Esp Salud Publica. 2019 Oct 9;93:e201910066.

Abstract

OBJECTIVE

Implementation of Shared Decision Making (SDM) in oncology is limited. The objective of the study was to determine the extent of physicians' awareness of Shared Decision Making (SDM) in their treatment of cancer patients, the usefulness that they assign to SDM, the role they play, their assessment of SDM, and perceptions of the main barriers and facilitators to its use.

METHODS

A questionnaire was completed by medical oncologists, radiation oncologists and general surgeons working in Andalusia (Spain). Sociodemographic, clinical-care and aspects of SDM variables were collected. SDM was evaluated using the SDM-Q-Doc questionnaire. Non-parametric contrasts were used to determine the possible differences between medical specialties.

RESULTS

The questionnaire was sent to 351 physicians. The response rate was 37.04%, 63 women and 67 men, with an average age of 45.6 years and 18.04 years' experience. Of these, 33.08% were medical oncologists, 34.61% radiation oncologists and 29.23% general surgeons. A total of 82.3% stated they had received no training in SDM, whereas 33.8% said they knew a lot about SDM and applied it in practice; 80% considered it to be very useful. In addition, 60% of respondents said they were mainly the ones who made the decisions on treatment. An evaluation of SDM on the SDM-Q-Doc scale showed that all the specialities scored more than 80/100. The main barriers to applying SDM were the difficulty patients experienced in understanding what they needed to know, the lack of decision aids and time.

CONCLUSIONS

Some 82% of physicians have no training in SDM and 66% don´t use it in practice, with decisions on treatment taken mainly by the physicians themselves. Strategies to increase training in SDM and to implement it into clinical practice are important.

摘要

目的

肿瘤学领域中共同决策(SDM)的实施情况有限。本研究的目的是确定医生在治疗癌症患者时对共同决策(SDM)的认知程度、他们赋予SDM的有用性、他们所扮演的角色、对SDM的评估,以及对其使用的主要障碍和促进因素的看法。

方法

西班牙安达卢西亚地区的肿瘤内科医生、放射肿瘤学家和普通外科医生完成了一份问卷。收集了社会人口统计学、临床护理和SDM变量方面的信息。使用SDM-Q-Doc问卷对SDM进行评估。采用非参数对比来确定医学专业之间可能存在的差异。

结果

问卷被发送给351名医生。回复率为37.04%,其中63名女性和67名男性,平均年龄45.6岁,平均从业经验18.04年。其中,33.08%是肿瘤内科医生,34.61%是放射肿瘤学家,29.23%是普通外科医生。共有82.3%的人表示他们没有接受过SDM方面的培训,而33.8%的人表示他们对SDM非常了解并在实践中应用;80%的人认为它非常有用。此外,60%的受访者表示他们主要是做出治疗决策的人。在SDM-Q-Doc量表上对SDM的评估显示,所有专业的得分都超过了80/100。应用SDM的主要障碍是患者在理解所需了解的内容方面存在困难、缺乏决策辅助工具和时间。

结论

约82%的医生没有接受过SDM方面的培训,66%的医生在实践中不使用它,治疗决策主要由医生自己做出。增加SDM培训并将其应用于临床实践的策略很重要。

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