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共同决策在提高患者对参与癌症临床试验满意度方面的中介作用。

The mediating effect of shared decision-making in enhancing patient satisfaction with participation in cancer clinical trials.

作者信息

Chang Wen-Wen, Wu Ming-Tzu, Chang Yun-Chen, Hu Wen-Yu

机构信息

School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.

PAREXEL International, Taipei, Taiwan.

出版信息

Asia Pac J Oncol Nurs. 2023 Jun 23;10(8):100265. doi: 10.1016/j.apjon.2023.100265. eCollection 2023 Aug.

Abstract

OBJECTIVE

The participation of patients with advanced cancer(s) in clinical trials is vital for new drug development. We aimed to investigate patients' decision-making processes and satisfaction with their decision (SWD) to participate; the study's purpose was to provide results that can help support high-quality research in clinical trials. In addition, we explored how shared decision-making (SDM) mediates the relationship between understanding informed consent forms and SWD to participate in a clinical trial.

METHODS

A cross-sectional study was conducted. A purposive sample of 111 cancer patients was recruited, and they completed a questionnaire on demographic characteristics, SDM, and decision-making satisfaction to participate in a clinical trial. Correlation and mediation analyses were used.

RESULTS

Participants aged under 65 years and with higher education reported high SWDs, and SDM significantly mediated the relationship between self-assessed understanding of informed consent forms and SWDs related to clinical trials.

CONCLUSIONS

SDM in patients with lung or liver cancer was a significant mediator between understanding the informed consent form and the patient's SWD. The higher the SWD level of participating in clinical trials, the better study team members' SDM involvement and the better the comprehension of informed consent forms. In addition, patients' age and education level should also be considered as influencing factors in SWD. This survey is the first in Taiwan to examine SDM in drug-related clinical trials. The study results provide evidence to support SDM in a clinical trial model and develop informed consent process policies in research facilities.

摘要

目的

晚期癌症患者参与临床试验对新药研发至关重要。我们旨在调查患者参与临床试验的决策过程及其对参与决策的满意度(SWD);该研究的目的是提供有助于支持高质量临床试验研究的结果。此外,我们还探讨了共同决策(SDM)如何在理解知情同意书与参与临床试验的SWD之间的关系中起中介作用。

方法

进行了一项横断面研究。招募了111名癌症患者的目的样本,他们完成了一份关于人口统计学特征、SDM以及参与临床试验决策满意度的问卷。使用了相关性分析和中介分析。

结果

65岁以下且受教育程度较高的参与者报告了较高的SWD,并且SDM显著中介了自我评估的对知情同意书的理解与与临床试验相关的SWD之间的关系。

结论

肺癌或肝癌患者的SDM是理解知情同意书与患者SWD之间的重要中介。参与临床试验的SWD水平越高,研究团队成员的SDM参与度越高,对知情同意书的理解也越好。此外,患者的年龄和教育水平也应被视为影响SWD的因素。这项调查是台湾首次在药物相关临床试验中考察SDM。研究结果为在临床试验模型中支持SDM以及在研究机构制定知情同意流程政策提供了证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5603/10372169/00b147e6e4a4/gr1.jpg

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