Rothenbacher D, Lutz M P, Porzsolt F
Department of Epidemiology, University of Ulm, Germany.
Eur J Cancer. 1997 Jul;33(8):1184-9. doi: 10.1016/s0959-8049(97)00034-8.
The aim of this study was to evaluate the extent to which hospitalised patients with advanced cancer and a palliative treatment goal wanted to be involved in the process of making treatment decisions and how well their physicians actually knew their preferences for participation. 59 hospitalised patients with non-curable cancer, 86 hospitalised patients with chronic non-neoplastic disease, and 115 non-hospitalised persons were surveyed with a standardised questionnaire. In addition, the physicians of the hospitalised patients were asked to complete a similar questionnaire. The majority of patients with advanced cancer wanted to decide either by themselves/mainly by themselves (9%) or to collaborate and decide together with their physician (73%), compared with 17% and 49%, respectively, of patients with chronic non-neoplastic disease, and 40% and 56%, respectively, of the non-hospitalised persons (difference between groups: P = 0.001). Younger age, higher education, employment and higher Karnofsky index were significantly associated with active involvement. The agreement of patients' preference with their physicians' assessment did not exceed chance. In conclusion, most patients wanted to participate in a decision regarding their treatment, although physicians were unaware of their patients' preferences.
本研究的目的是评估晚期癌症住院患者且以姑息治疗为目标时，其希望参与治疗决策过程的程度，以及他们的医生实际上对其参与偏好的了解程度。对59名患有不可治愈癌症的住院患者、86名患有慢性非肿瘤性疾病的住院患者和115名非住院人员进行了标准化问卷调查。此外，还要求住院患者的医生填写一份类似的问卷。大多数晚期癌症患者希望自己决定/主要自己决定（9%）或与医生合作共同决定（73%），相比之下，慢性非肿瘤性疾病患者分别为17%和49%，非住院人员分别为40%和56%（组间差异：P = 0.001）。年龄较小、受教育程度较高、就业以及卡氏评分较高与积极参与显著相关。患者偏好与医生评估的一致性未超过随机水平。总之，大多数患者希望参与有关其治疗的决策，尽管医生并不了解患者的偏好。
