Author Affiliations: Department of Health Statistics (Dr Tang), The Fourth Military Medical University, China; Department of Cardiopulmonary Circulation, Shanghai Pulmonary Hospital (Dr Wang), Tongji University, China; The School of Nursing and Health (Drs Du, Yang and Cui) and the First Affiliated Hospital (Dr Chen, Mss Dong, and Ms Liu), Zhengzhou University, China.
Cancer Nurs. 2023;46(2):111-119. doi: 10.1097/NCC.0000000000001071. Epub 2022 Mar 4.
Breast cancer patients wish to participate in the treatment decision-making, but the perceived participation was inconsistent with the willingness, leading to poor patient outcomes.
The aims of this study were to explore the perceived participation in the primary surgery decision-making among Chinese patients with early-stage breast cancer (BCa) and to analyze the relationships of demographic and clinical factors, participation competence, self-efficacy, social support, and doctors' promotion of participation with the guidance of the capability, opportunity, motivation-behavior system (the COM-B system).
Paper surveys were used to collect data from 218 participants. The participation competence, self-efficacy, social support, and the doctor facilitation of involvement were evaluated to measure factors related to perceived participation among early-stage BCa.
Perceived participation was low, and participants with a high level of participation competence, self-efficacy, and social support and who were employed and had a higher education level and higher family income perceived higher participation in primary surgery decision-making.
Perceived participation was low and may be facilitated by patients' internal and external factors during the decision-making process. Health professionals should be aware that patient participation in decision-making is a type of self-care health behavior, and targeted decision support interventions should be provided to facilitate participation.
Patient-perceived participation may be evaluated from the perspective of self-care management behaviors among BCa patients. Nurse practitioners should emphasize their important roles in providing information, patient education, and psychological support to better contribute to the course of the treatment decision-making process for BCa patients who faced primary surgery.
乳腺癌患者希望参与治疗决策，但感知到的参与与意愿不一致，导致患者结局较差。
本研究旨在探讨中国早期乳腺癌（BCa）患者对主要手术决策的感知参与，并根据能力、机会、动机-行为系统（COM-B 系统）分析人口统计学和临床因素、参与能力、自我效能、社会支持以及医生促进参与与感知参与的关系。
采用纸质问卷对 218 名参与者进行数据收集。评估参与能力、自我效能、社会支持以及医生对参与的促进作用，以衡量早期 BCa 中与感知参与相关的因素。
感知参与程度较低，而那些具有较高参与能力、自我效能和社会支持水平的、有工作的、受过高等教育和高家庭收入的参与者，对主要手术决策的参与程度更高。
感知参与程度较低，在决策过程中可能会受到患者内外因素的影响。卫生专业人员应认识到，患者参与决策是一种自我保健健康行为，应提供有针对性的决策支持干预措施，以促进参与。
可以从 BCa 患者自我保健管理行为的角度评估患者感知的参与程度。护士从业者应强调其在提供信息、患者教育和心理支持方面的重要作用，以更好地为面临主要手术的 BCa 患者的治疗决策过程做出贡献。
