The relationships among knowledge, self-efficacy, preparedness, decisional conflict, and decisions to participate in a cancer clinical trial.
The relationships among knowledge, self-efficacy, preparedness, decisional conflict, and decisions to participate in a cancer clinical trial.
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DOI：
10.1002/pon.3043
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发表时间：
2013-03
期刊：
影响因子：
3.6
通讯作者：
Meropol, N. J.
中科院分区：
文献类型：
--
作者：
Miller, S. M.;Hudson, S. V.;Egleston, B. L.;Manne, S.;Buzaglo, J. S.;Devarajan, K.;Fleisher, L.;Millard, J.;Solarino, N.;Trinastic, J.;Meropol, N. J.
癌症临床试验（CCT）是开发改进癌症疗法的重要工具;然而，参与率很低。关键的心理障碍存在，似乎影响患者的决定参加。知之甚少的知识，自我效能，准备，决策冲突，和病人决定参加CCT之间的关系。本研究的目的是确定是否准备考虑CCT作为一种治疗方案介导的知识，自我效能和决策冲突之间的关系。我们还探讨了较低水平的决策冲突是否与CCT招募的可能性更大相关。在一项前后测试干预研究中，癌症患者（N=105）在与医学肿瘤学家进行初次咨询之前被招募。对所有患者进行了简短的教育干预。患者自我报告调查回答评估了知识、自我效能、参与临床试验的准备、决策冲突和临床试验参与。准备被发现调解自我效能和决策冲突之间的关系（p=0.003的间接中介途径的测试决策冲突总分）。准备在调解知识对决策冲突的影响方面的作用更为有限。此外，初步证据表明，减少决策冲突与增加临床试验入组相关（p=0.049）。当患者感到更大的CCT自我效能感，并有更多的知识，他们觉得更准备作出CCT的决定。减少决策冲突，反过来，与决定参加临床试验。我们的研究结果表明，为决策做准备应该是未来干预措施的目标，以提高参与CCT。
Cancer clinical trials (CCTs) are important tools in the development of improved cancer therapies; yet, participation is low. Key psychosocial barriers exist that appear to impact a patient’s decision to participate. Little is known about the relationship among knowledge, self efficacy, preparation, decisional conflict, and patient decisions to take part in CCTs. The purpose of this study was to determine if preparation for consideration of a CCT as a treatment option mediates the relationship between knowledge, self-efficacy, and decisional conflict. We also explored whether lower levels of decisional conflict are associated with greater likelihood of CCT enrollment. In a pre-post test intervention study, cancer patients (N=105) were recruited before their initial consultation with a medical oncologist. A brief educational intervention was provided to all patients. Patient self-report survey responses assessed knowledge, self efficacy, preparation for clinical trial participation, decisional conflict, and clinical trial participation. Preparation was found to mediate the relationship between self-efficacy and decisional conflict (p=0.003 for a test of the indirect mediational pathway for the Decisional Conflict total score). Preparation had a more limited role in mediating the effect of knowledge on decisional conflict. Further, preliminary evidence indicated that reduced decisional conflict was associated with increased clinical trial enrollment (p=0.049). When patients feel greater CCT self-efficacy and have more knowledge they feel more prepared to make a CCT decision. Reduced decisional conflict, in turn, is associated with the decision to enroll in a clinical trial. Our results suggest that preparation for decision making should be a target of future interventions to improve participation in CCTs.
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