影响中国前列腺癌患者参与手术决策程度的因素：一项定性研究。
Factors influencing the degree of participation in surgical decision-making among Chinese patients with prostate cancer: A qualitative research.
作者信息
Cao Jie, Peng Chunxue, Lu Xiaoying, Zhou Lingjun, Wu Jing
机构信息
Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Nursing, Changhai Hospital, Naval Medical University, Shanghai, China.
出版信息
Asian J Urol. 2022 Apr;9(2):177-185. doi: 10.1016/j.ajur.2021.08.003. Epub 2021 Aug 27.
OBJECTIVE
There was increasingly demand of participation in surgical decision-making among Chinese patients with prostate cancer. However, due to the complex healthcare system and advanced care settings, it is quite challenging for the patients to gain sufficient support from the institute and the government. This research aimed to investigate the factors that impact the degree of participation in surgical decision-making among Chinese prostate cancer patients.
METHODS
A phenomenological approach of qualitative research based on the results of semi-structured interviews was adopted, to explore the influencing factors which hinder the participation in surgical decision-making. Consolidated Criteria for Reporting Qualitative Research were utilized. Up to 160 post-operative patients who had undergone radical prostatectomy along with 68 medical and nursing staffs, were purposively recruited in this research. This retrospective study was carried out from September 2018 to August 2019. After recording and transcribing the interviews, the interview materials were evaluated via the Colaizzi's seven step approach and the NVivo Version 10 software to analyze the interview content.
RESULTS
According to the analysis and summary of the interviews, there were three factors affecting the degree of participation in surgical decision-making. Firstly, insufficient information was provided by medical and nursing staffs because of their lack of time, proper communication skills, and career experience, as well as difficulties in the development of patient decision aid and inconsistent resource availability. Secondly, the cognitive level of decision-making among patients was relatively low due to poor psychological endurance, insufficient amount of education, senility, and less knowledge and information demand. Ultimately, decisions were constantly made by family members with/without patients.
CONCLUSIONS
The degree of participation of Chinese prostate cancer patients in the surgical decision-making had much space for improvement.
目的
中国前列腺癌患者对参与手术决策的需求日益增加。然而，由于医疗体系复杂且护理环境先进，患者要从机构和政府获得充分支持颇具挑战。本研究旨在调查影响中国前列腺癌患者手术决策参与程度的因素。
方法
采用基于半结构化访谈结果的现象学定性研究方法，探讨阻碍手术决策参与的影响因素。运用了《定性研究报告统一标准》。本研究有目的地招募了160名接受过前列腺癌根治术的术后患者以及68名医护人员。这项回顾性研究于2018年9月至2019年8月进行。在记录和转录访谈内容后，通过科莱齐的七步法和NVivo 10软件对访谈材料进行评估，以分析访谈内容。
结果
根据访谈的分析和总结，有三个因素影响手术决策参与程度。首先，医护人员提供的信息不足，原因包括他们缺乏时间、适当的沟通技巧和职业经验，以及患者决策辅助工具开发困难和资源获取不一致。其次，患者的决策认知水平相对较低，这是由于心理承受能力差、受教育程度不足、年老以及知识和信息需求较少。最后，决策由有/无患者参与的家庭成员做出。
结论
中国前列腺癌患者在手术决策中的参与程度有很大的提升空间。
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