Azuma Kanako, Kawaguchi Takashi, Yamaguchi Takuhiro, Motegi Sayuri, Yamada Kimito, Onda Kenji, Iwase Satoru, Unezaki Sakae, Takeuchi Hironori
Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan.
Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
Patient Prefer Adherence. 2021 May 18;15:1017-1026. doi: 10.2147/PPA.S295383. eCollection 2021.
The importance of shared decision-making (SDM) between physicians and patients is increasingly recognized. In Japan, patients have shown more willingness to participate in treatment if medical professionals provide sufficient information; however, relationships between physicians and patients have traditionally been asymmetric, with patients accepting information from physicians without discussion. To explore the benefits of SDM in cancer treatment, including confidence in treatment decisions, satisfaction with treatment, and trust in healthcare providers, this study developed Japanese versions of the Control Preference Scale (CPS) and Information Needs Questionnaire (INQ).
Reliability and validity of the CPS and INQ were tested with 49 breast cancer patients.
The CPS showed good test-retest reliability (kappa coefficient: 0.61, weighted kappa coefficient: 0.61, Kendall's tau coefficient: 0.61) and acceptable criterion validity. The INQ showed adequate consistency; the mean number of circular triads and coefficient of consistency were 3 (range 0-19) and 0.9 (range 0.37-1), respectively. Using the CPS and INQ to identify patients' roles in decision-making and information needs, results further suggested that breast cancer patients in Japan want to participate in SDM. Medical issues, including disease spread and cure, were found to be of high interest, while social and psychological issues, including sexual attractiveness, genetic risk, and family impact, tended to be low.
The Japanese CPS and INQ can be used to assess patients' needs to improve care. Further, as patients' information needs change along the care trajectory, these tools should be used throughout treatment.
医患之间共同决策（SDM）的重要性日益得到认可。在日本，如果医疗专业人员提供足够的信息，患者表现出更愿意参与治疗；然而，传统上医患关系是不对称的，患者在没有讨论的情况下接受医生提供的信息。为了探索共同决策在癌症治疗中的益处，包括对治疗决策的信心、对治疗的满意度以及对医疗服务提供者的信任，本研究开发了日语版的控制偏好量表（CPS）和信息需求问卷（INQ）。
对49名乳腺癌患者测试了CPS和INQ的信度和效度。
CPS显示出良好的重测信度（kappa系数：0.61，加权kappa系数：0.61，肯德尔tau系数：0.61）和可接受的效标效度。INQ显示出足够的一致性；循环三元组的平均数和一致性系数分别为3（范围0 - 19）和0.9（范围0.37 - 1）。使用CPS和INQ来确定患者在决策中的角色和信息需求，结果进一步表明日本的乳腺癌患者希望参与共同决策。发现包括疾病扩散和治愈在内的医疗问题关注度较高，而包括性吸引力、遗传风险和家庭影响在内的社会和心理问题关注度往往较低。
日语版的CPS和INQ可用于评估患者需求以改善护理。此外，由于患者的信息需求会随着护理轨迹而变化，这些工具应在整个治疗过程中使用。
