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癌症患者治疗偏好中的年龄和性别差异:来自新型治疗偏好量表的证据。

Age and Sex-Based Differences in Therapy Preferences Among Patients with Cancer: Evidence from a Novel Therapy Preference Scale.

作者信息

Dhakal Prajwal, Wichman Christopher S, Pozehl Bunny J, Elnair Radowan, Yellala Amulya, Mahato Kalika, Bhatt Vijaya Raj

机构信息

The University of Iowa.

University of Nebraska Medical Center.

出版信息

Res Sq. 2025 Jan 8:rs.3.rs-5743881. doi: 10.21203/rs.3.rs-5743881/v1.

Abstract

BACKGROUND

Patients' preferences are crucial to formulating personalized treatment plans. We developed a self-reported questionnaire, Therapy Preference Scale (TPS), to examine treatment preferences of patients with cancer.

METHODS

TPS has 30 questions-19 on patients' preferences on safety, quality of life, and treatment effectiveness, 8 questions on importance of various treatment characteristics, and 3 on patients' preferred intent of therapy, expenses, and life expectancy gain. We recruited 300 adults>18 years with a cancer diagnosis and categorized them into 4 age-by-sex groups (younger men<60 years, older men≥60 years, younger women<60 years, older women≥60 years). Kruskal-Wallis non-parametric ANOVA method was used to compare responses among 4 groups.

RESULTS

Older women, compared to other groups, were more likely to value maintenance of cognitive function and ability to perform daily activities. Older women were more likely to risk having a shorter life expectancy rather than facing the risk of long-term cognitive impairments. Younger men and women were more likely to accept more effective treatment, even if it caused significant pain. A higher percentage of younger men, compared to other groups, valued maintaining sex life. Older men and women were more likely to prefer oral pills over intravenous therapy.

CONCLUSION

Patient preferences may vary based on age and sex with older women prioritizing cognitive and physical function independence more frequently, whereas younger men and women willing to pursue more effective treatment options even with a greater risk of significant pain. TPS can elicit detailed preferences of an individual patient to facilitate shared decision-making with their oncologists.

摘要

背景

患者的偏好对于制定个性化治疗方案至关重要。我们开发了一份自我报告问卷,即治疗偏好量表(TPS),以检查癌症患者的治疗偏好。

方法

TPS有30个问题——19个关于患者对安全性、生活质量和治疗效果的偏好,8个关于各种治疗特征的重要性的问题,以及3个关于患者对治疗意图、费用和预期寿命增加的偏好。我们招募了300名年龄大于18岁且被诊断患有癌症的成年人,并将他们分为4个按年龄和性别的组(年龄小于60岁的年轻男性、年龄大于等于60岁的老年男性、年龄小于60岁的年轻女性、年龄大于等于60岁的老年女性)。采用Kruskal-Wallis非参数方差分析方法比较4组之间的回答。

结果

与其他组相比,老年女性更重视认知功能的维持和进行日常活动的能力。老年女性更愿意冒预期寿命较短的风险,而不是面临长期认知障碍的风险。年轻男性和女性更有可能接受更有效的治疗,即使这会导致严重疼痛。与其他组相比,更高比例的年轻男性重视维持性生活。老年男性和女性比静脉治疗更喜欢口服药物。

结论

患者的偏好可能因年龄和性别而异,老年女性更频繁地将认知和身体功能独立作为优先考虑因素,而年轻男性和女性即使面临更大的严重疼痛风险,也愿意追求更有效的治疗选择。TPS可以引出个体患者的详细偏好,以促进与肿瘤学家的共同决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e46/11760243/cfb641357ce0/nihpp-rs5743881v1-f0001.jpg

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