Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
Oncology Department, Weihai Central Hospital, Shandong, China.
Support Care Cancer. 2023 Jun 6;31(7):380. doi: 10.1007/s00520-023-07817-0.
Patients with advanced cancer are usually willing to participate in shared decision-making (SDM), but in clinical practice, patient participation is easily ignored. This study aimed to analyze the current SDM status of advanced cancer patients and related factors.
In quantitative research, we administered a cross-sectional survey to 513 advanced cancer patients in 16 tertiary hospitals in China. A sociodemographic information questionnaire, the Control Preference Scale (CPS), and Perceived-Involvement in Care Scale (PICS) were used to analyze current SDM status and influencing factors. Our qualitative research was based on the Ottawa Decision Support Framework (ODSF), and 17 advanced cancer patients were interviewed to explore their perceptions of SDM.
Our quantitative results show that patients' actual and expected decision-making participation differed; statistically significant influencing factors were age, insurance, and whether patients were worried about the therapeutic effects. We also found that dynamic decision-making mode changes, disease information acquisition, decision-making participation obstacles, and family members' roles affected patients' SDM through qualitative interviews.
Advanced cancer patients' SDM in China is dominated by sharing and continuously fluctuates. Influenced by Chinese traditional culture, family members play an important role in SDM. In clinical work, we should pay attention to the dynamic changes in patients' participation in decision-making and the role of family members.
晚期癌症患者通常愿意参与共同决策（SDM），但在临床实践中，患者的参与往往容易被忽视。本研究旨在分析晚期癌症患者的 SDM 现状及其相关因素。
在定量研究中，我们对中国 16 家三级医院的 513 名晚期癌症患者进行了横断面调查。采用社会人口统计学信息问卷、控制偏好量表（CPS）和参与关怀量表（PICS）分析当前 SDM 状况及其影响因素。我们的定性研究基于渥太华决策支持框架（ODSF），对 17 名晚期癌症患者进行了访谈，以探讨他们对 SDM 的看法。
定量结果表明，患者的实际和预期决策参与存在差异；年龄、保险和患者是否担心治疗效果是有统计学意义的影响因素。我们还通过定性访谈发现，动态决策模式的变化、疾病信息的获取、决策参与障碍以及家庭成员的角色影响了患者的 SDM。
中国晚期癌症患者的 SDM 以共享为主，且呈动态波动。受中国传统文化的影响，家庭成员在 SDM 中扮演着重要的角色。在临床工作中，我们应关注患者参与决策的动态变化以及家庭成员的作用。
