A Video Decision Aid Improves Informed Decision Making in Patients With Advanced Cancer Considering Palliative Radiation Therapy.
A Video Decision Aid Improves Informed Decision Making in Patients With Advanced Cancer Considering Palliative Radiation Therapy.
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DOI：
10.1016/j.jpainsymman.2019.08.014
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发表时间：
2019-12
影响因子：
4.7
通讯作者：
McCormick B
中科院分区：
文献类型：
--
作者：
Dharmarajan KV;Walters CB;Levin TT;Milazzo CA;Monether C;Rawlins-Duell R;Tickoo R;Spratt DE;Lovie S;Giannantoni-Ibelli G;McCormick B
晚期癌症患者对姑息性放射治疗（PRT）的认识存在未被认识到的差距。为转诊的晚期癌症住院患者制作视频辅助决策工具，并前瞻性检验其在降低决策不确定性、提高知识水平、提高治疗准备度和姑息治疗咨询准备度方面的效果，以及患者的可接受性。在纪念斯隆凯特琳癌症中心住院的40名晚期癌症患者观看了一段关于PRT和姑息治疗的决策辅助视频。通过6项知识调查、决策冲突量表的决策不确定性子量表和Likert工具评估患者接受放射治疗和/或姑息治疗咨询的准备程度，分别评估患者对PRT、决策不确定性、治疗准备和姑息治疗咨询的概念和逻辑知识。视频后的调查评估了患者对视频的接受程度。观看视频后，决策不确定性降低（28.3 vs. 21.7, p=0.02）；PRT知识提高（60.4比88.3,p<0.001）；PRT准备度增高（2.0比1.3,p=0.04）。对姑息治疗咨询的准备程度没有变化（p=0.58）。70%的患者觉得观看视频很舒服，并会强烈推荐给其他人（75%）。在晚期癌症住院患者中，视频决策辅助减少了决策的不确定性，提高了对PRT的认识，提高了对PRT的准备程度，并且受到了患者观众的好评。
Advanced cancer patients have unrecognized gaps in their understanding about palliative radiation therapy (PRT). To build a video decision aid for hospitalized patients with advanced cancer referred for PRT and prospectively test its efficacy in reducing decisional uncertainty, improving knowledge, increasing treatment readiness and readiness for palliative care consultation, and its acceptability among patients. Forty patients with advanced cancer hospitalized at Memorial Sloan Kettering Cancer Center watched a video decision aid about PRT and palliative care. Patients’ conceptual and logistical knowledge of PRT, decisional uncertainty, treatment readiness, and readiness for palliative care consultation were assessed before and after watching the video with a 6-item knowledge survey, the decisional uncertainty subscale of the Decisional Conflict Scale, and Likert instruments to assess readiness to accept radiation treatment and/or palliative care consultation, respectively. A post-video survey assessed the video’s acceptability among patients. After watching the video, decisional uncertainty was reduced (28.3 vs. 21.7, p=0.02); knowledge of PRT improved (60.4 vs. 88.3, p<0.001); and PRT readiness increased (2.0 vs. 1.3, p=0.04). Readiness for palliative care consultation was unchanged (p=0.58). Patients felt very comfortable (70%) watching the video and would highly recommend it (75%) to others. Among hospitalized patients with advanced cancer, a video decision aid reduced decisional uncertainty, improved knowledge of PRT, increased readiness for PRT, and was well-received by patient viewers.
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影响因子：
--
作者：
Volandes, Angelo E.;Lehmann, Lisa Soleymani;Gillick, Muriel R.
通讯作者：
Gillick, Muriel R.
影响因子：
105.7
作者：
Volandes, Angelo E.;Paasche-Orlow, Michael K.;Mitchell, Susan L.
通讯作者：
Mitchell, Susan L.
DOI：
10.1016/s0360-3016(96)00514-7
发表时间：
1997-01-15
影响因子：
7
作者：
vanDaal, WAJ;Bos, MA
通讯作者：
Bos, MA
影响因子：
3.6
作者：
Volandes, Angelo E.;Barry, Michael J.;Paasche-Orlow, Michael K.
通讯作者：
Paasche-Orlow, Michael K.
影响因子：
45.3
作者：
El-Jawahri, Areej;Podgurski, Lisa M.;Volandes, Angelo E.
通讯作者：
Volandes, Angelo E.