Riggan Kirsten A, Stewart Elizabeth A, Balls-Berry Joyce E, Venable Sateria, Allyse Megan A
Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA.
Department of Obstetrics & Gynecology, Mayo Clinic, Rochester, MN, USA.
J Patient Exp. 2021 Oct 20;8:23743735211049655. doi: 10.1177/23743735211049655. eCollection 2021.
Uterine fibroids are noncancerous tumors associated with significant morbidity among symptomatic patients. While medical and surgical treatments have expanded, hysterectomy remains common. We interviewed women diagnosed with uterine fibroids ( = 47) to explore their experiences and recommendations for shared decision-making. A majority were non-Hispanic Black, highly educated (51.1%), and had graduate degrees (40.4%). Participants with both positive and negative provider experiences expressed a desire for a more proactive therapeutic approach, including a presentation by their provider of the spectrum of medical and surgical treatment options, and greater provider recognition of the impact of symptoms on quality of life. Women advocated for expanded shared decision-making that acknowledged their contribution to their own treatment plan and felt early screening and improved patient/provider education of uterine fibroid symptoms would facilitate greater congruence between treatment approaches and patient goals. Perceptions of insufficient input into their treatment plans frequently served as a barrier to care-seeking and treatment acceptance among women with uterine fibroid symptoms. Improved discussion of treatment options in the context of the unique symptom burden and values of the patient may facilitate greater provider trust and acceptance of uterine fibroid treatment.
子宫肌瘤是一种非癌性肿瘤，在有症状的患者中会引发严重疾病。尽管医学和手术治疗方法有所增加，但子宫切除术仍然很常见。我们采访了被诊断为子宫肌瘤的女性（n = 47），以探讨她们的经历以及对共同决策的建议。大多数人是非西班牙裔黑人，受教育程度高（51.1%），拥有研究生学位（40.4%）。有过积极和消极就医经历的参与者都表示希望采用更积极主动的治疗方法，包括医生介绍各种医学和手术治疗选择，以及医生更充分认识到症状对生活质量的影响。女性主张扩大共同决策，承认她们对自身治疗方案的贡献，并认为早期筛查以及改善患者/医生对子宫肌瘤症状的教育，将有助于使治疗方法与患者目标更加契合。对于治疗方案参与度不足的认知，常常成为有子宫肌瘤症状的女性寻求治疗和接受治疗的障碍。在考虑患者独特的症状负担和价值观的背景下，改善对治疗选择的讨论，可能会增进医生与患者之间的信任，并提高对子宫肌瘤治疗的接受度。
