Treatment decisional regret among men with prostate cancer: Racial differences and influential factors in the North Carolina Health Access and Prostate Cancer Treatment Project (HCaP-NC)
Treatment decisional regret among men with prostate cancer: Racial differences and influential factors in the North Carolina Health Access and Prostate Cancer Treatment Project (HCaP-NC)
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DOI：
10.1002/cncr.29309
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发表时间：
2015-06-15
期刊：
影响因子：
6.2
通讯作者：
Bensen, Jeannette T.
中科院分区：
文献类型：
--
作者：
Morris, Bonny B.;Farnan, Laura;Bensen, Jeannette T.
研究背景已有研究表明，治疗决策后悔影响前列腺癌患者的生活质量;然而，有有限的研究，确定与治疗决定后悔相关的因素，特别是在一个种族多样化的患者人群中，已经延长了随访。方法Logistic回归分析被用来确定决策后悔和潜在预测因子之间的关联，在CaP诊断后约3年，348名非洲裔美国男性和446名白人美国男性的基于队列的研究中，794名研究参与者中，12%经历了治疗决定的后悔。决定性后悔与雄激素剥夺治疗有关（比值比[OR]，2.1; 95%置信区间[CI]，1.1-4.0），近期排尿困难（OR，3.4; 95% CI，1.6-7.3），对了解潜在治疗副作用的满意度（非常不满意：OR，13.3; 95%CI，5.5-32.2;有些不满意：OR，5.0; 95%CI，2.3-11.2;中性：OR，3.8; 95%CI，1.9-7.6），以及钙磷治疗对配偶关系的影响（严重受累：OR，3.9; 95% CI，2.0-7.6;轻度受累：OR，3.1; 95% CI，1.4-7.3;中性：OR，2.4; 95% CI，1.9-7.6）。年轻的非洲裔美国人更有可能经历比老年非洲裔美国人（OR，3.0; 95%CI，1.1-8.1），和老年非洲裔美国人不太可能经历比老年白人美国人（OR，0.2; 95%CI，0.1-0.7）的遗憾。潜在的干预措施应该涉及年轻的非洲裔美国人和患者配偶。增加的遗憾可能反映了治疗副作用对患者日常生活的意外影响;帮助患者将潜在的副作用与其个人情况联系起来可以提高患者满意度。癌症2015;121：2029-2035。(c)在对348名患有前列腺癌的非洲裔美国男性和446名患有前列腺癌的高加索裔美国男性的分析中，前列腺癌治疗决定后悔存在并且持续远远超过最初的诊断和治疗。年轻的非洲裔美国人更有可能报告遗憾，遗憾与满意度呈负相关，了解治疗的潜在副作用和治疗对配偶关系的影响。
BACKGROUNDIt has been demonstrated that treatment decisional regret affects quality of life in patients with prostate cancer (CaP); however, there are limited studies that identify factors associated with treatment decisional regret, particularly within a racially diverse patient population that has extended follow-up.METHODSLogistic regression analysis was used to determine associations between decisional regret and potential predictors in a population-based cohort of 348 African American men and 446 Caucasian American men approximately 3 years after CaP diagnosis.RESULTSOf 794 research participants, 12% experienced treatment decisional regret. Decisional regret was associated with androgen-deprivation therapy (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.1-4.0), recent urinary bother (OR, 3.4; 95% CI, 1.6-7.3), satisfaction with understanding potential treatment side effects (very unsatisfied: OR, 13.3; 95% CI, 5.5-32.2; somewhat unsatisfied: OR, 5.0; 95% CI, 2.3-11.2; neutral: OR, 3.8; 95% CI, 1.9-7.6), and CaP treatment effect on the spousal relationship (very affected: OR, 3.9; 95% CI, 2.0-7.6; somewhat affected: OR, 3.1; 95% CI, 1.4-7.3; neutral: OR, 2.4; 95% CI, 1.9-7.6). Younger African Americans were more likely to experience regret than older African Americans (OR, 3.0; 95% CI, 1.1-8.1), and older African Americans were less likely to experience regret than older Caucasian Americans (OR, 0.2; 95% CI, 0.1-0.7).CONCLUSIONSTreatment decisional regret remains an important issue in CaP survivors beyond initial treatment. Potential interventions should involve younger African Americans and patient spouses. Increased regret may reflect the unexpected influence of treatment side effects on the patient's everyday life; helping the patient relate potential side effects to his individual situation could improve patient satisfaction. Cancer 2015;121:2029-2035. (c) 2015 American Cancer Society.In an analysis of 348 African American men and 446 Caucasian American men with prostate cancer, prostate cancer treatment decisional regret is present and persistent well beyond initial diagnosis and treatment. Younger African Americans are more likely to report regret, and regret is negatively associated with satisfaction in understanding of the potential side effects of treatment and treatment effect on the spousal relationship.