Abe Masakazu, Hashimoto Hironobu, Soejima Azusa, Nishimura Yumiko, Ike Ami, Sugawara Michiko, Shimada Muneaki
Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan.
J Gynecol Oncol. 2025 May;36(3):e47. doi: 10.3802/jgo.2025.36.e47. Epub 2024 Nov 19.
This cross-sectional study aimed to understand the actual situation of shared decision-making (SDM) and identify the challenges of implementing SDM among Japanese gynecologic cancer patients and healthcare professionals (HCPs).
Adult Japanese women undergoing chemotherapy for endometrial or ovarian/fallopian tube cancer and HCPs who prescribed/administered treatment were enrolled. Data were collected via a web-based questionnaire. Primary endpoints were the actual and desired status of SDM for patients by preferred role (active, collaborative, passive), and important aspects in drug selection for patients and HCPs. SDM treatment preferences were determined using the Control Preferences Scale.
Respondents comprised 154 patients (77 for endometrial and 77 for ovarian/fallopian tube cancer), 153 physicians, 166 nurses, and 154 pharmacists. Among patients, 53.9% desired an active role in decision-making, and 55.8% participated; 25.3% desired a collaborative role, and 14.3% participated; and 20.8% desired a passive role, and 29.9% participated. Most patients with a collaborative role in decision-making (86.4%) were "very satisfied" or "somewhat satisfied" with their communication with physicians, compared with 60.4% and 73.9% of respondents with active and passive roles in decision-making, respectively. In daily practice, 23.5%, 47.6%, and 19.5% of physicians, nurses, and pharmacists, respectively, confirmed "awareness" of SDM. Regarding treatment expectations, patients ranked "complete elimination of cancer," and HCPs ranked "live longer" as the most important.
Most patients desire involvement in their treatment decisions. Additionally, treatment expectations differ between patients and HCPs. Increasing SDM awareness, implementing it systematically, and addressing patients' needs for collaborative roles in decision-making is essential.
本横断面研究旨在了解共同决策（SDM）的实际情况，并确定在日本妇科癌症患者和医疗保健专业人员（HCPs）中实施SDM所面临的挑战。
纳入接受子宫内膜癌或卵巢/输卵管癌化疗的成年日本女性以及开处方/给药治疗的HCPs。通过基于网络的问卷收集数据。主要终点是患者按偏好角色（主动、协作、被动）划分的SDM实际和期望状态，以及患者和HCPs在药物选择方面的重要方面。使用控制偏好量表确定SDM治疗偏好。
受访者包括154名患者（77名子宫内膜癌患者和77名卵巢/输卵管癌患者）、153名医生、166名护士和154名药剂师。在患者中，53.9%希望在决策中发挥主动作用，55.8%的患者参与其中；25.3%希望发挥协作作用，14.3%的患者参与其中；20.8%希望发挥被动作用，29.9%的患者参与其中。大多数在决策中发挥协作作用的患者（86.4%）对与医生的沟通“非常满意”或“有些满意”，而在决策中发挥主动和被动作用的受访者中这一比例分别为60.4%和73.9%。在日常实践中，分别有23.5%、47.6%和19.5%的医生、护士和药剂师确认对SDM有“认识”。关于治疗期望，患者将“癌症完全消除”列为最重要的，而HCPs将“活得更长”列为最重要的。
大多数患者希望参与治疗决策。此外，患者和HCPs的治疗期望存在差异。提高对SDM的认识并系统地实施它，以及满足患者在决策中对协作角色的需求至关重要。
