Patient factors affecting decision regret in the medical treatment process of gynecological diseases
Patient factors affecting decision regret in the medical treatment process of gynecological diseases
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DOI：
10.1186/s41687-019-0137-y
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发表时间：
2019-07-17
影响因子：
2.7
通讯作者：
Bito, Seiji
中科院分区：
文献类型：
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作者：
Tanno, Kiyomi;Bito, Seiji
为了确保患者继续接受治疗，患者对治疗决策过程感到满意至关重要。解决这个问题的一种方法是使用后悔的概念来评估医疗质量，它可以衡量“在决策中被说服”。本研究旨在使用日本版的决策后悔量表（DRS）阐明影响后悔的患者因素。方法对197例子宫肌瘤、卵巢肿瘤、子宫内膜异位症患者进行问卷调查。然后，我们通过多组比较，使用潜在类分析和路径分析，研究了日本DRS，日本SF-8作为健康相关生活质量（QOL）和患者因素之间的关系。结果最终样本包括102例患者。根据患者特征的潜在类别分析，将患者分为以下两组：许多已婚且有子女的患者和少数未婚且无子女的患者（1类），以及许多未婚且无子女的患者和少数已婚且有子女的患者（2类）。通过对两类受试者进行分组比较的路径分析显示，主观症状、偏好和手术程序（剖腹手术或腹腔镜手术）对后悔有直接影响。1级和2级后悔的影响因素的大小是不同的。对后悔的间接影响是通过心理成分总结来实现的。结论我们的研究结果表明，有必要提出考虑患者背景的治疗方法，并获得患者的知情同意。
Background To ensure that patients continue treatment, it is essential that the patient is satisfied with the decision-making process of the treatment. One way to address this is to assess the healthcare quality using the concept of regret, which can measure "Being convinced in decision-making." This study aimed to elucidate patient factors affecting regret using the Japanese version of the Decision Regret Scale (DRS). Methods A questionnaire survey was conducted with 197 patients with uterine myoma, ovarian tumors, and endometriosis. We then examined the relationship between the Japanese DRS, the Japanese SF-8 as a health-related quality of life (QOL), and patient factors using latent class analysis and path analysis through a multi-group comparison. Results The final sample comprised 102 patients. Patients were classified into the following two groups based on the latent class analysis of patient characteristics: many patients who were married and had children and a few patients who were unmarried and had no children (class 1), and many patients who were unmarried and had no children and a few patients who were married and had children (class 2). The path analysis through the group comparison of the two classes revealed that subjective symptoms, preferences, and surgical procedure (laparotomy or laparoscopic surgery) had a direct impact on regret. The magnitude of the influence factors for Class 1 and Class 2 Regret was different. The indirect effect on regret was through mental component summary. Conclusion Our results suggest that it is necessary to present treatment methods with consideration to patients' backgrounds and to obtain informed consent from patients.