南非前列腺癌男性的决策冲突与治疗方式相关，而与疾病知识无关：一项纵向前瞻性观察研究的基线结果。
Decisional Conflict is Associated with Treatment Modality and not Disease Knowledge in South African Men with Prostate Cancer: Baseline Results from a Longitudinal Prospective Observational Study.
机构信息
Department of Urology, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa.
Division of Radiation Oncology, Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa.
出版信息
Cancer Control. 2022 Jan-Dec;29:10732748221082791. doi: 10.1177/10732748221082791.
BACKGROUND
Decisional conflict (DC) is a psychological construct that an individual experiences in making a decision that involves risk, loss, regret, or challenges to one's values. This study assessed DC in a cohort of South African men undergoing curative treatment for localised prostate cancer (LPC). The objectives were to (1) to examine the association between DC and prostate cancer knowledge (PCK), demographics, state anxiety, prostate cancer anxiety and time to treatment and (2) to compare levels of DC between treatment groups [prostatectomy (RP) and external beam radiation (RT)].
METHOD
Data, comprising the Decisional Conflict Scale (DCS), Prostate Cancer Knowledge (PCK), State-Trait Anxiety Inventory (STAI-S), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and demographic data from 83 participants of a larger prospective longitudinal observational study examining depression, anxiety and health related quality of life (DAHCaP) were analysed.
RESULTS
The mean age of participants was 63 years (RP 61yrs and RT 65yrs; p< 0.001). Most were of mixed ancestry (72.3%). The total DCS scores between the treatment groups (RP 25.00 and RT 18.75; p = 0.037) and two DCS sub-scores-uncertainty (p 0.033, and support (p 0.048 were significantly higher in the RP group. A statistically significant negative correlation was observed between state anxiety and time between diagnosis and treatment in the RP group (Spearman's rho = -0.368; p = 0.030). There was no correlation between the DCS score and PCK within each treatment group (Spearman's rho RP = -0.249 and RT = -0.001).
CONCLUSION
Decisional conflict was higher in men undergoing RP. Men were more anxious in the RP group regarding the time treatment was received from diagnosis. No correlation was observed between DC and PCK. Pre-surgical management of DC should include shared decision making (SDM) which is cognisant of patients' values facilitated by a customised decision aid.
背景
决策冲突（DC）是指个体在面临涉及风险、损失、遗憾或挑战个人价值观的决策时所经历的一种心理建构。本研究评估了南非男性接受局部前列腺癌（LPC）根治性治疗时的决策冲突。目的是：（1）检验决策冲突与前列腺癌知识（PCK）、人口统计学、状态焦虑、前列腺癌焦虑和治疗时间之间的关系；（2）比较治疗组（前列腺切除术[RP]和外照射放疗[RT]）之间的决策冲突水平。
方法
从一项更大的前瞻性纵向观察研究中获取了 83 名参与者的数据，该研究评估了抑郁、焦虑和健康相关生活质量（DAHCaP），数据包括决策冲突量表（DCS）、前列腺癌知识（PCK）、状态特质焦虑量表（STAI-S）、前列腺癌焦虑量表（MAX-PC）和人口统计学数据。
结果
参与者的平均年龄为 63 岁（RP 组为 61 岁，RT 组为 65 岁；p<0.001）。大多数人具有混合血统（72.3%）。治疗组之间的总 DCS 评分（RP 组为 25.00，RT 组为 18.75；p=0.037）和两个 DCS 子评分（不确定性，p=0.033；支持，p=0.048）在 RP 组中明显更高。RP 组中状态焦虑与从诊断到治疗的时间之间存在显著负相关（Spearman 相关系数= -0.368；p=0.030）。每个治疗组中 DCS 评分与 PCK 之间均无相关性（RP 组 Spearman 相关系数= -0.249，RT 组 Spearman 相关系数= -0.001）。
结论
RP 组男性的决策冲突更高。RP 组男性在接受治疗的时间方面更加焦虑。DC 与 PCK 之间未观察到相关性。术前 DC 管理应包括共同决策（SDM），这是一种认知患者价值观的方法，需要使用定制的决策辅助工具来促进。
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