Coombs Lorinda A, Crowder Victoria, Black Madison, Tan Kelly, Ray Emily M, Ferrari Renée M, Kent Erin E, Reuland Daniel S, Bryant Ashley Leak
University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA.
Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
Psychooncology. 2025 May;34(5):e70173. doi: 10.1002/pon.70173.
Patients with metastatic breast cancer (mBC) and their families often have differing perspectives on treatment goals. This highlights the need for systematically eliciting patients' and care partners' values to ensure values-aligned treatment decisions. This study aimed to inform the development of a values assessment tool to facilitate communication of priorities and preferences with oncology clinicians.
Two rounds of semi-structured interviews were conducted with women with mBC from the Southeastern and Northeastern U.S. Recruitment included at least 50% of participants identifying as African American/Black, Latinx, Asian, American Indian, or Native American.
The initial round of 13 interviews yielded eight candidate domains. After confirmatory interviews with additional participants, the researchers identified nine final domains relevant to treatment decisions for mBC: desire not to appear sick; desire to help other women with breast cancer by participating in clinical research; financial concerns; living to care for a loved one; maintaining sexuality; maintaining quality of life; maximizing time away from medical appointments; minimizing and managing side effects; and slowing disease progression with an effective treatment.
Eliciting treatment decision values across multiple domains and effectively communicating them with clinicians is a crucial aspect of patient-centered care to align values with care goals. To help patients identify and express their values to clinicians, we are developing a values assessment tool specifically for mBC. Future research will pilot this tool to assess its impact on communication between clinicians and patients and health outcomes for women with mBC.
转移性乳腺癌（mBC）患者及其家属对治疗目标往往有不同的看法。这凸显了系统地了解患者及其护理伙伴价值观的必要性，以确保治疗决策与价值观相符。本研究旨在为开发一种价值观评估工具提供信息，以促进与肿瘤临床医生沟通优先事项和偏好。
对来自美国东南部和东北部的mBC女性患者进行了两轮半结构化访谈。招募的参与者中至少50%为非裔美国人/黑人、拉丁裔、亚裔、美洲印第安人或原住民。
第一轮的13次访谈产生了8个候选领域。在对其他参与者进行验证性访谈后，研究人员确定了与mBC治疗决策相关的9个最终领域：不想显得生病；希望通过参与临床研究帮助其他乳腺癌女性；经济担忧；活着照顾亲人；维持性生活；维持生活质量；尽量减少就医时间；最小化和管理副作用；以及通过有效治疗减缓疾病进展。
在多个领域了解治疗决策价值观并与临床医生有效沟通，是以患者为中心的护理的关键方面，可使价值观与护理目标保持一致。为帮助患者向临床医生识别并表达自己的价值观，我们正在开发一种专门针对mBC的价值观评估工具。未来的研究将对该工具进行试点，以评估其对临床医生与患者之间沟通以及mBC女性患者健康结局的影响。
