Yeo Hui Yee, Wong Jacqueline Hui Yi, Chan Suz Jack, Latu Anna Tiatia Fa'atoese, Han Catherine H, Anwar Mudassir, Marra Carlo A
School of Pharmacy, University of Otago, Dunedin, New Zealand.
Clinical Research Center, Hospital Seberang Jaya, Seberang Jaya, Penang, Malaysia.
Patient Prefer Adherence. 2023 Dec 22;17:3525-3537. doi: 10.2147/PPA.S443217. eCollection 2023.
Despite the importance of acknowledging patient preferences in treatment decision-making, little is known about the treatment preferences and the factors underlying those preferences of breast cancer patients. This study aims explore patient experience and perspective regarding treatment preferences and identify the important determinants that shape these preferences in the context of New Zealand.
Semi-structured online interviews comprised of six focus group discussions and five individual interviews were performed with 26 breast cancer patients. The interviews were recorded, transcribed, and analyzed using the reflexive thematic analysis approach.
Four main themes were derived: (1) positive treatment outcomes; (2) the negative impact of treatment-related side effects on quality of life; (3) treatment accessibility, availability, and timeliness; (4) cost of treatment. Patients revealed a strong preference towards treatments that yield longer survival, achieve remission, and prevent cancer recurrence. Additionally, patients favored treatments with minimal side effects that had minimal impact on their quality of life. There was a notable preference for treatments that were easily accessible and available in a timely manner. However, patients faced challenging decisions in balancing the costs of treatments with their benefits, leading to a consistent preference for treatments supported by government funding or medical insurance to alleviate financial burdens.
Our study reveals that breast cancer patients in New Zealand have different perceptions and preferences regarding cancer treatment. Patients frequently find themselves making trade-offs among various attributes of a treatment, aligning these decisions with their personal values and beliefs. By considering these preferences and trade-offs in future studies that measure patient preferences, healthcare professionals can enhance their support for patients in making informed choices that align with their values and priorities. Additionally, healthcare policymakers can develop patient-centered policies that cater to the unique needs and preferences of breast cancer patients.
尽管在治疗决策中承认患者偏好很重要，但对于乳腺癌患者的治疗偏好及其偏好背后的因素知之甚少。本研究旨在探讨患者在治疗偏好方面的经历和观点，并确定在新西兰背景下塑造这些偏好的重要决定因素。
对26名乳腺癌患者进行了由六次焦点小组讨论和五次个人访谈组成的半结构化在线访谈。访谈进行了录音、转录，并采用反思性主题分析方法进行分析。
得出了四个主要主题：（1）积极的治疗结果；（2）治疗相关副作用对生活质量的负面影响；（3）治疗的可及性、可用性和及时性；（4）治疗费用。患者表现出对能带来更长生存期、实现缓解并预防癌症复发的治疗有强烈偏好。此外，患者倾向于选择副作用最小且对其生活质量影响最小的治疗方法。对于易于获得且能及时提供的治疗方法有明显偏好。然而，患者在平衡治疗成本与收益方面面临具有挑战性的决策，导致始终倾向于选择有政府资助或医疗保险支持的治疗方法以减轻经济负担。
我们的研究表明，新西兰的乳腺癌患者对癌症治疗有不同的认知和偏好。患者经常发现自己在治疗的各种属性之间进行权衡，使这些决策与他们的个人价值观和信念保持一致。通过在未来衡量患者偏好的研究中考虑这些偏好和权衡，医疗保健专业人员可以加强对患者做出符合其价值观和优先事项的明智选择的支持。此外，医疗保健政策制定者可以制定以患者为中心的政策，以满足乳腺癌患者的独特需求和偏好。
