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基于网络的决策辅助工具对考虑进行乳房重建的乳腺癌患者的影响:一项随机对照试验。

Effects of a web-based decision aid on breast cancer patients considering a breast reconstruction: a randomized controlled trial.

作者信息

Wang Yan, Zhang Qingyue, Cheng Chang, Wang Xiaoyuan, Yin Jian, Qiang Wanmin

机构信息

Tianjin Medical University Cancer Institute & Hospital; National Clinical Research Center for Cancer; Tianjin's Clinical Research Center for Cancer; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education; Key Laboratory of Cancer Prevention and Therapy, Tianjin, Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin, 300060, China.

出版信息

BMC Womens Health. 2025 May 7;25(1):217. doi: 10.1186/s12905-025-03754-8.

Abstract

PURPOSE

Due to the variety of surgical methods, breast cancer patients may face dilemmas regarding decision-making. Web-based decision aids (WDAs) are interactive tools that help patients make informed decisions by meeting their needs both inside and outside the hospital, providing real-time decision assistance, and being more practical and convenient. Although the incidence of breast cancer ranks first among female cancers in China, studies focusing specifically on the use of WDAs in breast cancer patients have not been conducted in the country. The objective of this study was to determine the effects of WDAs on breast cancer patients considering a breast reconstruction.

METHODS

A total of 70 patients with breast cancer were randomized, with 63 completing the whole trial. The control group used paper-based decision aids, which they could use freely in the ward to obtain health information support. The intervention group used web-based decision aids, including decision assessment, decision support, and decision evaluation, which they could use anytime and anywhere on their mobile phones. The study measured decision conflict, preferred decision-making roles, unmet needs, and decision satisfaction at baseline and before and after the intervention.

RESULTS

No differences were found in the demographic and clinical features between the two groups. Compared with the control group, the intervention group had lower scores for the dimensions of decision support and decision effectiveness, decision uncertainty, total score of decision conflict and information needs, work and financial needs, access and continuity of care, coping, sharing and emotional needs, and total score of unmet information needs (P all < 0.05). Patients in the intervention group had a higher proportion of active and collaborative roles, higher scores in the information, deliberation, decision, and global satisfaction and confidence dimensions, and a higher total score for decision satisfaction (P all < 0.05).

CONCLUSION

WDAs are a convenient tool for promoting collaborative decision making, satisfying information needs, reducing decision conflict, and improving decision satisfaction. In addition, the development of WDAs avoids the limitations of region and time, and provides sufficient knowledge for patients to improve their medical experience.

TRIAL REGISTRATION

Registration Number: ChiCTR2400092924 Dated: 26.11.2024.

摘要

目的

由于手术方法多样,乳腺癌患者在决策方面可能面临困境。基于网络的决策辅助工具(WDA)是一种交互式工具,通过满足患者在医院内外的需求、提供实时决策辅助且更实用便捷,帮助患者做出明智决策。尽管乳腺癌发病率在中国女性癌症中位居首位,但国内尚未开展专门针对WDA在乳腺癌患者中应用的研究。本研究的目的是确定WDA对考虑进行乳房重建的乳腺癌患者的影响。

方法

共纳入70例乳腺癌患者,63例完成整个试验。对照组使用纸质决策辅助工具,可在病房自由使用以获取健康信息支持。干预组使用基于网络的决策辅助工具,包括决策评估、决策支持和决策评价,可在手机上随时随地使用。研究在基线以及干预前后测量决策冲突、偏好的决策角色、未满足的需求和决策满意度。

结果

两组在人口统计学和临床特征方面未发现差异。与对照组相比,干预组在决策支持和决策有效性、决策不确定性、决策冲突总分和信息需求、工作和财务需求、医疗服务的可及性和连续性、应对、分享和情感需求以及未满足信息需求总分等维度上得分更低(所有P值均<0.05)。干预组患者主动和协作角色的比例更高,在信息、审议、决策和总体满意度及信心维度上得分更高,决策满意度总分也更高(所有P值均<0.05)。

结论

WDA是促进共同决策、满足信息需求、减少决策冲突和提高决策满意度的便捷工具。此外,WDA的开发避免了地域和时间的限制,为患者提供了足够的知识以改善就医体验。

试验注册

注册号:ChiCTR2400092924 日期:2024年11月26日

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0287/12060549/4fd7b74c0171/12905_2025_3754_Fig1_HTML.jpg

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