Decisional involvement and information preferences of patients with hematologic malignancies
Decisional involvement and information preferences of patients with hematologic malignancies
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DOI：
10.1182/bloodadvances.2020003044
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发表时间：
2020-11-10
期刊：
影响因子：
7.5
通讯作者：
Lee, Stephanie J.
中科院分区：
文献类型：
--
作者：
Loh, Kah Poh;Tsang, Mazie;Lee, Stephanie J.
了解恶性血液病患者的决策参与和信息偏好可能有助于优化医患之间关于治疗决策的沟通，并使决策过程与患者的偏好保持一致。我们描述并研究了与血液恶性肿瘤患者决策参与、信息来源和信息呈现偏好相关的因素。在一项多中心观察性研究中，我们从2003年9月至2007年6月招募了216例任何阶段的血液恶性肿瘤患者。患者被问及他们的决策参与偏好（控制偏好量表），信息来源（包括最有用的信息来源），以及对肿瘤学家介绍治疗成功信息的偏好。我们使用多变量逻辑回归来确定与决策参与偏好和信息来源（医生与非医生）的有用性相关的因素。34%、38%和28%的患者分别首选患者导向、共享和医生导向的方法。医生和计算机/互联网是最常见的信息来源; 42%的人认为医生是最有用的来源。多变量分析显示，大学以下学历的患者（与研究生教育相比）不太可能将他们的医生视为最有用的来源（校正比值比[AOR]，0.46; 95%置信区间（CI），0.21-1.00），而急性白血病患者（与其他血液癌症相比）更有可能认为他们的医生是最有用的来源（AOR，2.49; 95%CI，1.07-5.80）。在沟通治疗成功率方面，70% >= 1首选方法，88%首选百分比介绍。我们的研究表明，决策参与和信息偏好各不相同，应明确评估的一部分，每个决策遇到。
Understanding decisional involvement and information preferences in patients with hematologic malignancies may help to optimize physician-patient communication about treatment decisions and align the decision-making processes with patients' preferences. We described and examined factors associated with preferences of patients with hematologic malignancies for decisional involvement, information sources, and presentation of information. In a multicenter observational study, we recruited 216 patients with hematologic malignancies of any stage from September 2003 to June 2007. Patients were asked about their decisional involvement preferences (Control Preferences Scale), information sources (including most useful source of information), and preferences for their oncologists' presentation of treatment success information. We used multivariate logistic regressions to identify factors associated with decisional involvement preferences and usefulness of information sources (physicians vs nonphysicians). Patient-directed, shared, and physician-directed approaches were preferred in 34%, 38%, and 28% of patients, respectively. Physicians and computer/Internet were the most common information sources; 42% perceived physicians as the most useful source. On multivariate analysis, patients with less than a college education (vs postgraduate education) were less likely to perceive their physician as the most useful source (adjusted odds ratio [AOR], 0.46; 95% confidence interval (CI), 0.21-1.00), whereas patients with acute leukemia (vs other blood cancers) were more likely to perceive their physician as the most useful source (AOR, 2.49; 95% CI, 1.07-5.80). In terms of communicating treatment success rates, 70% >= 1 preferred method(s), and 88% preferred presentation in percentages. Our study suggests that decisional involvement and information preferences vary and should be assessed explicitly as part of each decision-making encounter.