Quality of life in active surveillance and the associations with decision-making-a literature review.
Quality of life in active surveillance and the associations with decision-making-a literature review.
复制标题
DOI：
10.21037/tau.2017.12.34
复制
发表时间：
2018-03
影响因子：
2
通讯作者：
Bellardita L
中科院分区：
文献类型：
--
作者：
Menichetti J;Valdagni R;Bellardita L
已经进行了几项关于选择主动监测（AS）的低风险前列腺癌（PCa）男性的生活质量（QoL）的研究。虽然最近的综述显示现有的生活质量研究缺乏一致性，但已确定了一些关键点，包括决策（DM）相关问题及其对生活质量的潜在影响。欧洲肿瘤学院国际工作队最近也强调了这一主题的重要性。然而，据我们所知，没有研究专门整理了关于患有AS的低风险PCa男性中DM和QoL之间相关性的科学知识。我们进行了文献综述，以填补这一空白，采取系统的方法来检索和选择的文章，包括DM和生活质量的措施。在检索到的272篇文章中，我们选择了9篇同时使用DM和QoL指标的观察性定量文章。这些研究中考虑最多的DM方面是决策冲突和患者在DM过程中的角色偏好，以及健康相关的QoL方面。这些研究包括42项评估DM的经验测量和QoL的经验测量之间的关系。在这些评估中，23例（55%）为阳性且显著。他们主要关注患者相关（决策自我效能，决策控制和知识）和外部（社会支持的存在，DM过程中的协作角色，不同医生的影响）DM方面之间的关系，以及选择后的生活质量。这些研究的结果揭示了与AS中DM和QoL相关的研究和临床实践的关键挑战。这些措施包括采用以人为本的观点，其中临床医生，护理人员及其互动也包括在评估中，并考虑DM和AS旅程中个人的心理社会存在经验。需要更多地关注诊断后的DM过程，以及患者可能必须或想要审查其决定的所有其他时刻。医疗保健专业人员在使男性能够做出明智的决定并在AS期间照顾他们的健康和福祉方面发挥着关键作用。在培训来自不同学科的医疗保健专业人员方面仍有工作要做，以便根据低风险PCa患者及其家庭成员的需求，在共享DM和AS的模型中共同工作。
Several studies have been conducted on the quality of life (QoL) in men with low risk prostate cancer (PCa) who choose active surveillance (AS). While recent reviews have shown a lack of consistency among the available QoL-studies, a few key points have been identified, including decision-making (DM)-related issues and their potential effect on QoL. The importance of this theme has also been recently highlighted by the international task force of the European School of Oncology. However, to our knowledge, there are no studies that have specifically marshalled scientific knowledge on the association between DM and QoL among men with low-risk PCa undergoing AS. We performed a literature review to fill this gap, taking a systematic approach to retrieving and selecting articles that included both DM and QoL measures. Among the 272 articles retrieved, we selected nine observational, quantitative articles with both DM and QoL measures. The most considered DM aspects within these studies were decisional conflict and preference for the patient’s role in the DM process, as well as health-related QoL aspects. The studies included 42 assessments of the relationship between an empirical measure of DM and an empirical measure of QoL. Among these assessments, 23 (55%) were both positive and significant. They mostly concerned the relationship between patient-related (decisional self-efficacy, decisional control and knowledge) and external (presence of social support, collaborative role within the DM process, and influence of different physicians) DM aspects, as well as the QoL after choice. The findings of these studies revealed key challenges to research and clinical practice related to DM and QoL in AS. These include adopting a person-centred perspective where clinicians, caregivers and their interactions are also included in evaluations and where the psychosocial existential experience of individuals within the DM and AS journey is considered. Much more attention needs to be paid to the DM process after diagnosis, as well as to all the other moments where patients may have to or want to review their decision. Healthcare professionals play a key role in enabling men to make informed decisions and to take care of their health and well-being during AS. There is still work that needs to be done in training healthcare professionals from different disciplines to work together in a model of shared DM and AS tailored to the needs of low-risk PCa patients and their family members.
登录
查看更多内容
影响因子：
3.5
作者：
Clayman, Marla L.;Gulbrandsen, Pal;Morris, Megan A.
通讯作者：
Morris, Megan A.
影响因子：
45.3
作者：
Clark, JA;Inui, TS;Talcott, JA
通讯作者：
Talcott, JA
影响因子：
2.1
作者：
Esper, P;Mo, F;Pienta, KJ
通讯作者：
Pienta, KJ
影响因子：
3.6
作者：
Brehaut, JC;O'Connor, AM;Feldman-Stewart, D
通讯作者：
Feldman-Stewart, D
影响因子：
3.1
作者：
Cuypers, Maarten;Lamers, Romy E. D.;Kil, Paul J. M.
通讯作者：
Kil, Paul J. M.