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有轻微可疑筛查乳房 X 光照片的患者的决策辅助工具:一项试点研究。

A Decision Aid for Patients With Minimally Suspicious Screening Mammograms: A Pilot Study.

机构信息

University of Virginia.

Oncology Nursing in the School of Nursing, University of Virginia.

出版信息

Oncol Nurs Forum. 2022 Aug 18;49(5):471-479. doi: 10.1188/22.ONF.471-479.

Abstract

OBJECTIVES

To determine the feasibility and acceptability of using a decision aid (DA) in a breast surgery clinic.

SAMPLE & SETTING: 42 patients with minimally suspicious mammograms and two physicians participated in this study at an outpatient breast specialty clinic in Virginia.

METHODS & VARIABLES: A quasiexperimental single group pilot study was conducted to determine the feasibility of DecisionKEYS, a theory-based, interactive DA intervention. Patients with minimally suspicious mammogram results chose between breast biopsy or close imaging follow-up. The Decisional Conflict Scale was used to measure decisional conflict. The Decision-Making Quality Scale was used to evaluate the overall decision process. Postintervention physician and patient feedback evaluated feasibility and acceptability.

RESULTS

Participants and physicians rated the DA as helpful. Decisional Conflict Scale scores were low before and after the intervention. Physicians reported the DA was feasible for workflow, and the majority reported using the DA in making final recommendations. Management recommendation (breast biopsy, close imaging follow-up) changed in 26 of 42 cases from pre- to postintervention. The majority of participants underwent breast biopsy.

IMPLICATIONS FOR NURSING

The feasibility and acceptability of the DA were beneficial to patients and clinic workflow.

摘要

目的

确定在乳腺外科诊所使用决策辅助工具(DA)的可行性和可接受性。

样本和设置

42 名患有低度可疑乳腺 X 光片的患者和 2 名医生在弗吉尼亚州的一家门诊乳腺专科诊所参与了这项研究。

方法和变量

进行了一项准实验性单组试点研究,以确定基于理论的交互式决策辅助工具 DecisionKEYS 的可行性。具有低度可疑乳腺 X 光片结果的患者可以选择乳腺活检或密切影像学随访。使用决策冲突量表来衡量决策冲突。使用决策质量量表评估整个决策过程。干预后的医生和患者反馈评估了可行性和可接受性。

结果

参与者和医生认为 DA 很有帮助。决策冲突量表在干预前后得分较低。医生报告说 DA 对工作流程是可行的,并且大多数医生报告说在做出最终建议时使用了 DA。在 42 例病例中,有 26 例从干预前到干预后管理建议(乳腺活检、密切影像学随访)发生了变化。大多数参与者接受了乳腺活检。

对护理的意义

DA 的可行性和可接受性对患者和诊所的工作流程都有益。

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