Beyer Katharina, Venderbos Lionne D F, Roobol Monique J, Giles Rachel H, Verhagen Paul, Barod Ravi, Wintner Lisa M, Jewett Michael A S, Van Hemelrijck Mieke, Kinsella Netty
Department of Urology, Erasmus MC Cancer Institute Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Translational Oncology and Urology Research (TOUR), King's College London, London, UK.
BJU Int. 2025 Jun;135(6):953-959. doi: 10.1111/bju.16635. Epub 2025 Jan 8.
To explore patients' experience of decision making regarding treatment of localised kidney cancer.
A total of 21 patients with localised kidney cancer, across three countries, participated in either four focus groups or seven semi-structured interviews that lasted on average 2 h. Focus groups and interviews were all conducted in the participants' native language, recorded, transcribed and (if applicable) translated into English. Thematic analysis was used to develop a codebook and identify themes.
All participants expressed a desire to be actively involved in the treatment decision-making process. However, due to the emotional toll of the cancer journey, which often necessitates quick decisions, actively engaging in the decision-making process was described as challenging. The study revealed 12 key themes. These themes included the impact of diagnostic paths, patient characteristics, patient empowerment, health literacy, source of support, fear of recurrence, trust in treatment and healthcare providers, shared decision making (SDM), professional interaction, personal belief system, and organisational and administrative issues.
The findings highlight the complexity of decision making, underscoring the desire for patient involvement, SDM, and clear communication. We reveal a significant gap between research recommendations and clinical practice, emphasising the need to translate research findings to clinical application to enhance patient-centred care.
探讨患者在局限性肾癌治疗决策方面的经历。
来自三个国家的总共21名局限性肾癌患者参加了四个焦点小组或七次半结构式访谈,平均持续2小时。焦点小组和访谈均以参与者的母语进行,录音、转录并(如适用)翻译成英文。采用主题分析法制定编码手册并确定主题。
所有参与者都表示希望积极参与治疗决策过程。然而,由于癌症历程带来的情感负担,这往往需要迅速做出决定,因此积极参与决策过程被认为具有挑战性。该研究揭示了12个关键主题。这些主题包括诊断途径的影响、患者特征、患者赋权、健康素养、支持来源、对复发的恐惧、对治疗和医疗服务提供者的信任、共同决策(SDM)、专业互动、个人信仰体系以及组织和管理问题。
研究结果突出了决策的复杂性,强调了患者参与、共同决策和清晰沟通的愿望。我们揭示了研究建议与临床实践之间的重大差距,强调需要将研究结果转化为临床应用,以加强以患者为中心的护理。