Division of Hematology and Oncology, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Psychooncology. 2021 Feb;30(2):167-175. doi: 10.1002/pon.5545. Epub 2020 Sep 22.
Shared decision-making (SDM) occurs when physicians and patients jointly select treatment that aligns with patient care goals. Incorporating patient preferences into the decision-making process is integral to successful decision-making. This study explores factors influencing treatment selection in older patients with early-stage breast cancer (EBC).
This qualitative study included women age ≥65 years with EBC. To understand role preferences, patients completed the Control Preferences Scale. Semi-structured interviews were conducted to explore patients' treatment selection rationale. Interview transcripts were analyzed using a constant comparative method identifying major themes related to treatment selection.
Of 33 patients, the majority (48%) desired shared responsibility in treatment decision-making. Interviews revealed that EBC treatment incorporated three domains: Intrinsic and extrinsic influences, clinical characteristics, and patient values. Patients considered 19 treatment selection themes, the most prioritized including physician trust and physical side effects.
Because preferences and approach to treatment selection varied widely in this sample of older, EBC patients, more research is needed to determine best practices for preference incorporation to optimize SDM at the time of treatment decisions.
当医生和患者共同选择符合患者护理目标的治疗方案时，就会发生共享决策（SDM）。将患者的偏好纳入决策过程对于成功决策至关重要。本研究探讨了影响老年早期乳腺癌（EBC）患者治疗选择的因素。
本定性研究纳入了年龄≥65 岁的 EBC 女性患者。为了了解角色偏好，患者完成了控制偏好量表。进行半结构化访谈，以探讨患者的治疗选择依据。使用恒定性比较方法分析访谈记录，确定与治疗选择相关的主要主题。
在 33 名患者中，大多数（48%）希望在治疗决策中共同承担责任。访谈显示，EBC 治疗包含三个领域：内在和外在影响、临床特征和患者价值观。患者考虑了 19 个治疗选择主题，最优先考虑的主题包括医生信任和身体副作用。
由于本研究中这组老年 EBC 患者的偏好和治疗选择方法差异很大，因此需要进一步研究确定最佳的偏好纳入方法，以在治疗决策时优化 SDM。
