What do patients consider when making decisions about treatment for hepatitis C?
What do patients consider when making decisions about treatment for hepatitis C?
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DOI：
10.1016/j.amjmed.2005.05.029
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发表时间：
2005-12-01
影响因子：
5.9
通讯作者：
Garcia-Tsao, G
中科院分区：
文献类型：
--
作者：
Fraenkel, L;McGraw, S;Garcia-Tsao, G
目的：很少有数据从患者的角度描述慢性丙型肝炎感染的决策。在这项研究中，我们试图调查的因素，影响患者的决定，因为他们认为治疗丙型肝炎infection.SUBJECTS：参加门诊肝病诊所的Concreative患者被招募。采用有目的的抽样，包括患者目前正在治疗或最近接受治疗的慢性丙型肝炎感染与聚乙二醇干扰素和利巴韦林Lis以及其患者谁拒绝therapeutic.METHODS：我们进行了焦点小组，直到达到专题饱和。所有焦点小组由同一位博士级高级研究员主持，并采用恒定比较方法分析数据。结果：共有40例患者（80%男性）参加了8个焦点小组。影响患者决策的因素，出现最频繁的焦点小组的考虑风险利益权衡，保护价值，药物学，参与者的概念化丙型肝炎感染，社会问题，和医生的recommendations.CONCLUSION：理想情况下，复杂的决策是基于油仔细考虑的权衡相关的可用选项。我们的研究结果表明，除了干扰素和利巴韦林的风险和益处外，患者的治疗决定还受到多种因素的影响。通过了解这些因素，医生可以通过以下方式改善丙型肝炎感染的决策：1）确定患者的决定是否受到药物学或保护价值观的影响，2）了解患者对其疾病的概念化如何影响他们对治疗的态度，（3）确保患者理解社会责任不一定排除治疗，因为如果出现不良反应，影响变得不可容忍。(c)2005年爱思唯尔公司All rights reserved.
PURPOSE: There are few data describing decision-making in chronic hepatitis C infection from the patient's perspective. In this Study, we sought to investigate the factors that influence patients' decisions as they consider treatment for hepatitis C infection.SUBJECTS: Consecutive patients attending outpatient liver clinics were recruited. Purposeful sampling was employed to include patients who were Currently being treated or had recently been treated for chronic hepatitis C infection with pegylated-interferon and ribavirin Lis well its patients who had refused therapy.METHODS: We conducted focus groups Until thematic saturation was reached. All focus groups were facilitated by the same PhD-level senior research scientist, and constant comparative methods were used to analyze the data.RESULTS: A total of 40 patients (80% male) participated in 8 focus groups. The factors influencing patients' decision-making that emerged most frequently during the focus groups were consideration of risk benefit tradeoffs, protected values, heuristics, participants' conceptualization of hepatitis C infection, social issues, and physicians' recommendations.CONCLUSION: Ideally, complex decision-making is based oil careful consideration of the tradeoffs related to available options. Our findings Suggest that patients' treatment decisions are influenced by Multiple factors besides the risks and benefits of interferon and ribavirin. By being aware of these factors physicians can improve decision-making in hepatitis C infection by 1) determining whether patients' decisions are biased by heuristics or protect Values, 2) understanding how patients' conceptualization of their illness influences their attitudes toward therapy, and by 3) ensuring that patients understand that social responsibilities need not necessarily preclude treatment because therapy can be discontinued if adverse effects become intolerable. (c) 2005 Elsevier Inc. All rights reserved.