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癌症患者对肿瘤学中共同决策和决策辅助的看法。

Cancer patients' perspective on shared decision-making and decision aids in oncology.

机构信息

Klinik für Innere Medizin II Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.

üBAG/MVZ Onkologische Kooperation Harz GbR, Kösliner Str. 14, 38642, Goslar, Germany.

出版信息

J Cancer Res Clin Oncol. 2021 Jun;147(6):1725-1732. doi: 10.1007/s00432-021-03579-6. Epub 2021 Mar 7.

Abstract

PURPOSE

Shared Decision-Making (SDM) enhances patients' satisfaction with a decision, which in turn increases compliance with and adherence to cancer treatment. SDM requires a good patient-clinician relationship and communication, patients need information matching their individual needs, and clinicians need support on how to best involve the individual patient in the decision-making process. This survey assessed oncological patients' information needs and satisfaction, their preferred information in patient decision aids (PDAs), and their preferred way of making decisions regarding their treatment.

METHODS

Questionnaires were distributed among attendees of a lecture program on complementary and alternative medicine in oncology of which 220 oncological patients participated.

RESULTS

Participants reported a generally high need for information-correlating with level of education-but also felt overwhelmed by the amount. The latter proved particularly important during consultation. Use of PDAs increased satisfaction with given information but occurred in less than a third of the cases. Most requested contents for PDAs were pros and cons of treatment options and lists of questions to ask. The vast majority of patients preferred SDM to deciding alone. None wanted their physician to decide for them.

CONCLUSIONS

There is a high demand for SDM but a lack of conclusive evidence on the specific information needs of different types of patients. Conversation between patients and clinicians needs encouragement and support. PDAs are designed for this purpose and have the potential to increase patient satisfaction. Their scarce use in consultations calls for easier access to and better information on PDAs for clinicians.

摘要

目的

共同决策(SDM)可提高患者对决策的满意度,进而提高癌症治疗的依从性和遵从性。SDM 需要良好的医患关系和沟通,患者需要匹配其个体需求的信息,而临床医生需要支持如何最好地让个体患者参与决策过程。本调查评估了肿瘤患者的信息需求和满意度、他们在患者决策辅助工具(PDA)中偏好的信息,以及他们对治疗决策的首选方式。

方法

在肿瘤学补充和替代医学讲座项目的与会者中分发了问卷,其中 220 名肿瘤患者参与了该项目。

结果

参与者报告了普遍较高的信息需求——与教育程度相关——但也感到信息量过大。后者在咨询过程中显得尤为重要。使用 PDA 提高了对给定信息的满意度,但在不到三分之一的情况下发生。PDA 中最需要的内容是治疗方案的优缺点和要问的问题列表。绝大多数患者更喜欢 SDM 而不是独自决策。没有人希望医生替他们做决定。

结论

人们对 SDM 的需求很高,但对不同类型患者的具体信息需求缺乏确凿的证据。需要鼓励和支持患者与临床医生之间的对话。PDA 就是为此而设计的,有可能提高患者的满意度。它们在咨询中的使用很少,这就需要为临床医生提供更方便的获取途径和更好的 PDA 信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa87/11801991/196a374d35e0/432_2021_3579_Fig1_HTML.jpg

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