Patient information sources when facing repair of abdominal aortic aneurysm.
Patient information sources when facing repair of abdominal aortic aneurysm.
复制标题
面临腹主动脉瘤修复的患者信息来源。
DOI：
10.1016/j.jvs.2019.04.460
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发表时间：
2020
影响因子：
4.3
通讯作者：
Kougias,
中科院分区：
文献类型：
--
作者：
Anderson,PeterB;Wanken,ZacharyJ;Perri,JenniferL;Columbo,JesseA;Kang,Ravinder;Spangler,EmilyL;Newhall,Karina;Brooke,BenjaminS;Dosluoglu,Hasan;Lee,EugeneS;Raffetto,JosephD;Henke,PeterK;Tang,GaleL;Mureebe,Leila;Kougias,
当存在相互竞争的修复选择时，例如腹主动脉瘤（AAA）的治疗，共同的医疗决策是最重要的。我们试图了解患者的预先存在的知识AAA的来源，以更好地告知治疗医生对患者的术前consultation.MethodsWe的需求进行了多中心调查，在20退伍军人事务部医院在美国各地的AAA研究的首选开放与血管内修复的一部分，面临AAA修复的患者。管理一个有效的调查工具，以检查可用的信息来源和患者常用的，以了解他们的修复方案。该调查是由研究人员之前，病人有任何互动与血管外科医生，因为调查数据收集前的血管诊所visit.ResultsPreliminary分析数据从99例患者表明，我们的队列主要是男性（99%）和老年人（平均年龄73岁）。患者通常有高血压（86%）、既往心肌梗死（32%）、糖尿病（32%）和超重（58%）病史。病人到达他们的外科医生的办公室预约有限的信息。大多数患者（52%）报告称，他们根本没有与其初级保健医生讨论过AAA修复术的选择，一半（50%）的患者报告称，他们对不同手术选择的看法没有受到任何人的影响。略少于一半的患者报告称，他们没有收到任何关于开放性外科动脉瘤修复术和主动脉瘤腔内修复术的信息（分别为41%和37%）。很少有患者表示使用互联网作为他们的主要信息来源开放手术动脉瘤修复术和主动脉瘤腔内修复术（分别为10%和11%）。不到五分之一的患者搜索互联网或自行访问其他信息来源。大多数血管外科医生应该假设，患者将在第一次血管手术预约时对他们可用的治疗方案了解甚少。
ObjectiveShared medical decision making is most important when there are competing options for repair such as in treatment of abdominal aortic aneurysm (AAA). We sought to understand the sources of patients' pre-existing knowledge about AAA to better inform treating physicians about patients' needs for preoperative counseling.MethodsWe performed a multicenter survey of patients facing AAA repair at 20 Veterans Affairs hospitals across the United States as part of the Preferences for Open Versus Endovascular Repair of AAA study. A validated survey instrument was administered to examine the sources of information available and commonly used by patients to learn about their repair options. The survey was administered by study personnel before the patient had any interaction with the vascular surgeon because survey data were collected before the vascular clinic visit.ResultsPreliminary analysis of data from 99 patients showed that our cohort was primarily male (99%) and elderly (mean age 73 years). Patients commonly had a history of hypertension (86%), prior myocardial infarction (32%), diabetes (32%), and were overweight (58%). Patients arrived at their surgeon's office appointment with limited information. A majority of patients (52%) reported that they had not talked to their primary care physician at all about their options for AAA repair, and one-half (50%) reported that their view of the different surgical options had not been influenced by anyone. Slightly less than one-half of patients reported that they did not receive any information about open surgical aneurysm repair and endovascular aortic aneurysm repair (41% and 37%, respectively). Few patients indicated using the internet as their main source of information about open surgical aneurysm repair and endovascular aortic aneurysm repair (10% and 11%, respectively).ConclusionsPatients are commonly referred for AAA repair having little to no information regarding AAA pathology or repair options. Fewer than one in five patients searched the internet or had accessed other sources of information on their own. Most vascular surgeons should assume that patients will present to their first vascular surgery appointment with minimal understanding of the treatment options available to them.