Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer
Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer
复制标题
DOI：
10.1111/j.1475-6773.2005.00383.x
复制
发表时间：
2005-06-01
影响因子：
3.4
通讯作者：
Katz, SJ
中科院分区：
文献类型：
--
作者：
Lantz, PM;Janz, NK;Katz, SJ
目标。为了更好地理解“偏好敏感护理”背景下的医疗决策，我们调查了与乳腺癌患者对所接受手术类型和决策过程满意度相关的因素。数据来源/数据收集。以底特律和洛杉矶大都会地区新近诊断的乳腺癌患者为样本（N = 1633），从监测、流行病学和最终结果肿瘤登记处获得人口统计学和临床数据，并通过邮寄调查获得自我报告的心理社会和满意度数据（78.4%的回复率）。研究设计。在横断面设计中，采用多变量逻辑回归来确定与三种满意度测量相关的社会人口学和临床因素：对手术类型的低满意度、对决策过程的低满意度和决策后悔。主要的发现。总的来说，手术和决策过程的满意度都很高，决策后悔率很低。少数民族妇女和低收入妇女对决策的满意度较低或后悔的可能性更大。此外，患者对决策参与的偏好与他们实际参与程度之间的匹配是满意度和决策后悔/矛盾心理的有力指标。虽然参与程度低于偏好是低满意度和后悔的重要指标，但参与程度高于偏好也是一个风险因素。接受乳房切除术而不进行乳房重建的女性更有可能报告手术满意度较低(优势比[OR] = 1.54, p
Objective. To better understand medical decision making in the context of "preference sensitive care,'' we investigated factors associated with breast cancer patients' satisfaction with the type of surgery received and with the decision process.Data Sources/Data Collection. For a population-based sample of recently diagnosed breast cancer patients in the Detroit and Los Angeles metropolitan areas (N = 1,633), demographic and clinical data were obtained from the Surveillance, Epidemiology, and End Results tumor registry, and self-reported psychosocial and satisfaction data were obtained through a mailed survey ( 78.4 percent response rate).Study Design. Cross-sectional design in which multivariable logistic regression was used to identify sociodemographic and clinical factors associated with three satisfaction measures: low satisfaction with surgery type, low satisfaction with the decision process, and decision regret.Principal Findings. Overall, there were high levels of satisfaction with both surgery and the decision process, and low rates of decision regret. Ethnic minority women and those with low incomes were more likely to have low satisfaction or decision regret. In addition, the match between patient preferences regarding decision involvement and their actual level of involvement was a strong indicator of satisfaction and decision regret/ambivalence. While having less involvement than preferred was a significant indicator of low satisfaction and regret, having more involvement than preferred was also a risk factor. Women who received mastectomy without reconstruction were more likely to report low satisfaction with surgery (odds ratio [OR] = 1.54, p