Johnson J D, Roberts C S, Cox C E, Reintgen D S, Levine J S, Parsons M
University of South Florida College of Medicine, Tampa, USA.
J Surg Oncol. 1996 Nov;63(3):183-6. doi: 10.1002/(SICI)1096-9098(199611)63:3<183::AID-JSO9>3.0.CO;2-9.
Previous studies have shown that whereas nearly all cancer patients want information, far fewer wish to make treatment decisions. Although breast cancer patients who were given a choice of lumpectomy versus mastectomy and were encouraged to make the decision were believed to do better psychologically, a 1994 study refuted this. Some authors suggest that patient personality style is an important consideration in decisional preference.
Newly diagnosed breast cancer patients (n = 76) were surveyed within 6 months of surgery. They answered seven questions about patient and physician roles in the decision-making process. Additionally, they completed the Miller Behavioral Style Scale (MBSS), which categorizes "monitors," or information seekers, and "blunters," or information avoiders. Chi-square analyses were used to explore the relationship of personality style and age to treatment decision-making preferences.
Although 80% of women wanted a role in decision making, 74% wanted their surgeons to make a recommendation and when given, 94% followed the recommended treatment plan. Monitors and blunters were equally likely to want physician recommendations. Younger women, particularly those under age 40, were more likely to want a physician's recommendation. Of those women who had specific fears about their cancer (76%), only half of them revealed such fears to their doctors.
The notion that health care consumers, particularly younger ones, desire an independent choice of treatment was contradicted in this study. Physicians are encouraged to provide information and to probe regarding the fears of breast cancer patients in order to reduce anxiety while recognizing that treatment recommendations are desired by most women.
以往研究表明，几乎所有癌症患者都希望获取信息，但希望做出治疗决策的患者却少得多。尽管人们认为，对于可选择乳房肿瘤切除术还是乳房切除术并被鼓励做出决策的乳腺癌患者来说，其心理状况会更好，但1994年的一项研究驳斥了这一观点。一些作者认为，患者的个性风格是决策偏好的一个重要考量因素。
对新诊断出的乳腺癌患者（n = 76）在手术后6个月内进行了调查。他们回答了7个关于患者和医生在决策过程中角色的问题。此外，他们还完成了米勒行为风格量表（MBSS），该量表将“监测者”（即信息寻求者）和“钝化者”（即信息回避者）进行了分类。采用卡方分析来探究个性风格和年龄与治疗决策偏好之间的关系。
尽管80%的女性希望参与决策，但74%的女性希望外科医生给出建议，而当给出建议时，94%的女性遵循了推荐的治疗方案。“监测者”和“钝化者”同样有可能希望得到医生的建议。年轻女性，尤其是40岁以下的女性，更有可能希望得到医生的建议。在那些对自己的癌症有特定恐惧的女性中（76%），只有一半向医生透露了这种恐惧。
本研究与医疗保健消费者，尤其是年轻消费者希望独立选择治疗方案的观点相矛盾。鼓励医生提供信息并探究乳腺癌患者的恐惧，以减轻焦虑，同时认识到大多数女性希望得到治疗建议。
