Managing uncertainty about treatment decision making in early stage prostate cancer: A randomized clinical trial
Managing uncertainty about treatment decision making in early stage prostate cancer: A randomized clinical trial
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DOI：
10.1016/j.pec.2009.09.009
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发表时间：
2009-12-01
影响因子：
3.5
通讯作者：
Blyler, Diane
中科院分区：
文献类型：
--
作者：
Mishel, Merle H.;Germino, Barbara B.;Blyler, Diane
目的：本研究的目的是研究的影响，以理论为基础的决策不确定性管理干预（DMUMI）提供新诊断的前列腺癌患者的信息，沟通技巧和个人设计的prompts.Methods：一项随机临床试验进行了使用3 × 2设计与干预和对照组，包括白人和非洲裔美国人的男子。一般线性混合模型被用来比较干预组随着时间的推移。结果：显着的主要影响，为治疗组被发现的不确定性管理（癌症知识、问题解决和医患沟通）、医疗沟通能力、信息资源的数量和有用性以及决策后悔。干预措施是有效的，在不确定性管理的白人和非洲裔美国人的男子，特别是在准备有能力的病人，提高知识，解决问题的能力，信息资源和沟通技巧。使用疾病的不确定性理论，特定的技能，选择了一个专注于前因的uncertaints.Practice影响：在治疗决策的背景下，患者和其他支持需要有关疾病的信息，治疗方案和副作用，但他们也需要沟通技巧培训之前的治疗决策咨询。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Objective: The purpose of this study was to examine the effects of a theory-based decision-making uncertainty management intervention (DMUMI) providing newly diagnosed prostate cancer patients with information, communication skills and personally designed prompts.Methods: A randomized clinical trial was conducted using a 3 x 2 design with intervention and control groups including both Caucasian and African-American men. General linear mixed models were used to compare intervention groups over time.Results: Significant main effects for the treatment groups were found for uncertainty management (cancer knowledge, problem-solving, and patient-provider communication), medical communication competence, number and helpfulness of resources for information, and decisional regret.Conclusion: The intervention was effective in uncertainty management for Caucasian and African-American men, specifically in preparing competent patients with improved knowledge, problem-solving skills, information resources, and communication skills. Using the Uncertainty in Illness Theory, specific skills were selected with a focus on the antecedents of uncertainty.Practice implications: In the treatment decision-making context, patients and supportive others need information about disease, treatment options and side effects but they also need communication skills training prior to the treatment decision consultation. (C) 2009 Elsevier Ireland Ltd. All rights reserved.