Heuser Christian, Schellenberger Barbara, Ernstmann Nicole, Diekmann Annika, Krüger Emily, Schreiber Leonie, Scholl Isabelle, Ansmann Lena
Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Bonn, 53127, Germany.
Chair for Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, 50933, Germany.
J Multidiscip Healthc. 2023 Feb 11;16:397-409. doi: 10.2147/JMDH.S397300. eCollection 2023.
This study aimed (1) to analyze patients' perceived shared decision-making (SDM) experiences over 4 weeks between patients participating or not in multidisciplinary tumor conferences (MTCs) and (2) to analyze the association of patients' active participation in and organizational variables of MTCs with patients' perceived SDM experience directly after MTC.
From the N=317 patients, this observational study included patient surveys, observations, and audio transcripts from MTCs with (N=82) and without (N=145) patient participation in six breast and gynecologic cancer centers. We performed t tests for within- and between-group comparisons and linear regression with "patients' perceived SDM experiences in MTC" as the dependent variable.
Patients' perceived SDM experiences increased at 4 weeks after MTC (p<0.001) with lower perceived SDM experiences for participating versus nonparticipating patients (p<0.001). Linear regression showed that the organizational variable "round table seating arrangement" was significantly associated with higher perceived SDM experiences compared with a theater or U-shape arrangement (beta=-0.38, p=0.043; beta=-0.69, p=0.010) directly after MTC.
Results provide first insights into patients' perceived SDM experiences in MTCs. SDM in MTCs is associated with organizational variables of MTCs. A round table seating arrangement in MTCs with patient participation seems important for patients' perceived SDM experiences. The relatively low perceived SDM experiences of participating patients directly after MTC indicates room for improvement, eg concerning patient-centered communication.
本研究旨在（1）分析参与或未参与多学科肿瘤会议（MTC）的患者在4周内感知到的共同决策（SDM）体验，以及（2）分析患者在MTC中的积极参与和组织变量与MTC结束后患者感知到的SDM体验之间的关联。
在6个乳腺癌和妇科癌症中心，对N = 317名患者进行了这项观察性研究，包括患者调查、观察以及有患者参与（N = 82）和无患者参与（N = 145）的MTC音频记录。我们进行了组内和组间比较的t检验，并以“患者在MTC中感知到的SDM体验”为因变量进行线性回归分析。
MTC后4周，患者感知到的SDM体验有所增加（p < 0.001），参与会议的患者与未参与会议的患者相比，感知到的SDM体验较低（p < 0.001）。线性回归分析表明，与剧院式或U形座位安排相比，组织变量“圆桌座位安排”与MTC结束后更高的感知SDM体验显著相关（β = -0.38，p = 0.043；β = -0.69，p = 0.010）。
研究结果首次揭示了患者在MTC中感知到的SDM体验。MTC中的SDM与MTC的组织变量相关。对于患者感知到的SDM体验而言，患者参与的MTC中的圆桌座位安排似乎很重要。参与会议的患者在MTC结束后立即感知到的SDM体验相对较低，这表明仍有改进空间，例如在以患者为中心的沟通方面。
