Calderon Caterina, Fernández-Montes Ana, Gustems Marina, Roncero Lucia, Peña-López Jesús, Asensio-Martínez Elena, Muñoz-Sánchez Mar, Jimenez-Fonseca Paula
Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
Department of Medical Oncology, Complejo Hospitalario Universitario de Orense, Orense, Spain.
BMC Palliat Care. 2025 Jul 1;24(1):174. doi: 10.1186/s12904-025-01806-2.
Patients with advanced cancer often wish to be involved in medical decisions but may vary according to sociodemographic and clinical factors. This study examined how these variables relate to patients' preferred roles in decision-making.
Data from 1198 advanced cancer patients were collected via self-administered questionnaires and clinical records. The Control Preferences Scale was used to classify patients into three profiles: Patient Control (decisions mainly made by the patient), Shared Control (decisions made jointly with the physician), and Physician Control (decisions primarily led by the physician). Associations with sociodemographic and psychological variables were analyzed.
Among participants, 53% were in the Patient Control group, 10% in the Shared Control group, and 37% in the Physician Control group. Sociodemographic variables were significantly associated with decision-making profiles: men and participants with higher education (secondary or above) were more represented in the Physician Control group (41% and 43%), while women and unemployed participants predominated in the Patient Control group (both 57%). In contrast, clinical variables such as tumor site, treatment type, and disease stage showed no significant associations. Regarding psychological characteristics, the Physician Control group reported lower levels of distress and higher levels of positive adjustment (p <.05) compared to the other groups.
Decision-making preferences among advanced cancer patients depend predominantly on sociodemographic and psychological factors, rather than clinical variables. Patients deferring decisions to physicians experience lower distress and better psychological adjustment. Personalized communication informed by patient background and coping styles may improve patient-centered care and outcomes.
晚期癌症患者通常希望参与医疗决策，但这可能因社会人口统计学和临床因素而异。本研究探讨了这些变量与患者在决策中偏好角色的关系。
通过自填问卷和临床记录收集了1198例晚期癌症患者的数据。使用控制偏好量表将患者分为三种类型：患者控制（主要由患者做出决策）、共同控制（与医生共同做出决策）和医生控制（主要由医生主导决策）。分析了与社会人口统计学和心理变量的关联。
在参与者中，53%属于患者控制组，10%属于共同控制组，37%属于医生控制组。社会人口统计学变量与决策类型显著相关：男性和受过高等教育（中学及以上）的参与者在医生控制组中占比更高（分别为41%和43%），而女性和失业参与者在患者控制组中占主导（均为57%）。相比之下，肿瘤部位、治疗类型和疾病阶段等临床变量未显示出显著关联。在心理特征方面，与其他组相比，医生控制组报告的痛苦水平较低，积极适应水平较高（p <.05）。
晚期癌症患者的决策偏好主要取决于社会人口统计学和心理因素，而非临床变量。将决策推迟给医生的患者痛苦水平较低，心理适应更好。根据患者背景和应对方式进行个性化沟通可能会改善以患者为中心的护理和治疗结果。
