Hollen P J, Hobbie W L
College of Nursing, Northeastern University, Boston, MA 02115, USA.
J Pediatr Oncol Nurs. 1996 Jul;13(3):121-33; discussion 135-7. doi: 10.1177/104345429601300304.
The specific aims of this descriptive, comparative study were (1) to compare the decision-making quality and prevalence of risk behaviors (smoking, alcohol consumption, and illicit drug use) between 52 cancer-surviving adolescents and their peers; (2) to compare the relationship of decision-making quality and risk behavior prevalence in a subset of survivors who had a history of therapy with cognitive threat due to late effects of treatment to those without cognitive threat; and (3) to test the hypothesis that the higher the number of quality decision criteria adhered to, the fewer the risk behaviors exhibited by cancer-surviving adolescents. Findings indicated that the majority of teen survivors reported practicing poor-quality decision making for five of the seven criteria (peers, four of seven). There were no significant differences in decision making between teen survivors and their peers nor between survivors with cognitive threat and those without. Peers were significantly more likely to engage in one or more risk behaviors than teen survivors, but comparisons with two normative samples (state and national) revealed that cigarette smoking and alcohol use of the teen survivors were comparable with the general population. There was no significant difference in risk behaviors between survivors with a history of therapy with cognitive threat and those without. Survivors who reported higher adherence to quality decision criteria were less likely to report exhibiting risk behaviors than those with poorer decision making. Using the context of late effects due to cancer treatment, oncology nurses need to provide guidance in quality decision making as well as in risk behavior education.
（1）比较52名癌症幸存青少年与其同龄人在决策质量和风险行为（吸烟、饮酒及非法药物使用）方面的差异；（2）比较有因治疗晚期效应导致认知威胁治疗史的幸存者亚组与无认知威胁的幸存者亚组在决策质量和风险行为发生率方面的关系；（3）检验以下假设：癌症幸存青少年坚持的高质量决策标准数量越多，其表现出的风险行为就越少。研究结果表明，大多数青少年幸存者报告称，在七个标准中的五个方面（同龄人方面为七个标准中的四个）决策质量较差。青少年幸存者与其同龄人之间，以及有认知威胁的幸存者与无认知威胁的幸存者之间在决策方面均无显著差异。同龄人比青少年幸存者更有可能从事一种或多种风险行为，但与两个标准样本（州和全国）的比较显示，青少年幸存者的吸烟和饮酒情况与一般人群相当。有认知威胁治疗史的幸存者与无此治疗史的幸存者在风险行为方面无显著差异。报告更高程度坚持高质量决策标准的幸存者比决策质量较差的幸存者更不太可能报告表现出风险行为。在癌症治疗晚期效应的背景下，肿瘤护理人员需要在高质量决策以及风险行为教育方面提供指导。
