Treatment decision-making by men with localized prostate cancer: the influence of personal factors
Treatment decision-making by men with localized prostate cancer: the influence of personal factors
复制标题
DOI：
10.1016/s1078-1439(02)00209-0
复制
发表时间：
2003-03-01
影响因子：
2.7
通讯作者：
Yang, C
中科院分区：
文献类型：
--
作者：
Berry, DL;Ellis, WJ;Yang, C
目的：对于许多患有局限性前列腺癌的男性来说，关于治疗方式没有明确的答案或明确的选择。这种高风险的治疗决定是在巨大不确定性的背景下做出的。本研究的目的是系统地记录局限性前列腺癌男性报告的治疗决策中有意义且相关的方面。方法：对 44 名诊断为局限性前列腺癌 6 个月内的男性进行焦点小组和个人访谈。使用内容分析和扎根理论分析技术，确定和描述了男性治疗决策的主要方面和过程。结果：参与者从有影响的个人病史因素开始报告他们的经历，然后详细描述信息收集和预期治疗结果的重要影响以及其他个人的癌症病史和/或共同意见。 44 名参与者中的 20 名 (45%) 严重依赖他人的意见或历史的影响来做出决定，但 44 名参与者中只有 10 名 (22.7%) 报告此人是他们的医生。解释了一个常见的过程，“为我做出最好的选择”。结论：临床医生认为男性是根据可靠信息做出合理的治疗决定，但这项研究记录了不同的现实。对患者有关药物治疗和患者自身医疗因素的教育还不够。将个人因素和医疗因素纳入对话的诊所就诊对话可以指导男性针对局部前列腺癌做出“最佳选择”。 (C) 2003 Elsevier Science Inc. 保留所有权利。
Objectives: For many men with localized prostate cancer, there is no definite answer or unequivocal choice regarding treatment modality. This high-stakes treatment decision is made in the context of great uncertainty. The purpose of this study is to systematically document meaningful and relevant aspects of treatment decision-making reported by men with localized prostate cancer. Methods: Focus groups and individual interviews were conducted with 44 men who were within 6 months of a diagnosis of localized prostate cancer. Using content analysis and grounded theory analytic techniques, major aspects and processes of men's treatment decision making are identified and described. Results: The participants reported their experiences beginning with influential personal history factors, followed by detailed descriptions of information gathering and the important influence of expected treatment outcomes and other individuals' cancer histories and/or shared opinions. Twenty of the 44 (45%) participants relied heavily on the influence of another's opinion or history to finalize a decision, yet only 10 of the 44 (22.7%) reported this individual to be their physician. A common process, "making the best choice for me" was explicated. Conclusion: Clinicians assume that men are making rational treatment decisions based on reliable information, yet this study documents a different reality. Patient education about medical therapies and the patients' own medical factors is not enough. A clinic visit dialogue that brings personal factors to the conversation along with medical factors can guide a man to making his "best choice" for localized prostate cancer. (C) 2003 Elsevier Science Inc. All rights reserved.