Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China.
Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China.
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DOI：
10.7314/apjcp.2015.16.15.6311
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Xing Li;M. Dong;J. Wen;Li Wei;Xiao-kun Ma;Yan-Fang Xing;Yun Deng;Zhan-hong Chen;Jie Chen;D. Ruan;Zexiao Lin;Tian‐tian Wang;Dong-hao Wu;Xu Liu;Hai-Tao Hu;Jianhai Lin;Zhuang Li;Yuanli Liu;Q. Xia;Chang-chang Jia;Xiangyuan Wu;Q. Lin
中科院分区：
文献类型：
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作者：
Xing Li;M. Dong;J. Wen;Li Wei;Xiao-kun Ma;Yan-Fang Xing;Yun Deng;Zhan-hong Chen;Jie Chen;D. Ruan;Zexiao Lin;Tian‐tian Wang;Dong-hao Wu;Xu Liu;Hai-Tao Hu;Jianhai Lin;Zhuang Li;Yuanli Liu;Q. Xia;Chang-chang Jia;Xiangyuan Wu;Q. Lin
背景在中国大陆，老年癌症患者的疾病认知主要依赖于患者家属。我们制定了一个阶段性的程序，以提高他们对疾病的认识。材料与方法研究对象为224名来自中国南方9家主要医院的老年癌症患者。向负责每例患者的肿瘤学家发放问卷，以评估家属与患者之间的互动、患者对其疾病的认识以及参与医疗决策的情况。在第一个治疗周期后，在家庭的合作下向患者提供更多的疾病信息。然后记录患者对其疾病的认识和参与医疗决策的情况。结果224例老年癌症患者中，26例（11.6%）自行决策，125例（55.8%）委托家属决策。下属家庭成员在决策中的被动作用显著。参与医疗决策的患者往往对自己的疾病有更多的了解。然而，与疾病意识相反，患者对违反医疗建议的意识与其参与医疗决策的程度相关。约20%的老年癌症患者对诊断、分期和预后的认识有所提高。约5%的人更积极地参与医疗决策。结论中国老年癌症患者对疾病的认知和医疗决策的参与程度有限，且依赖于其家庭状况。我们开发的阶段性程序，以提高病人的疾病意识证明是有效的。
BACKGROUND In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. MATERIALS AND METHODS Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. RESULTS Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision- making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. CONCLUSIONS Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.