Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer
Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer
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DOI：
10.1038/bjc.2012.61
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发表时间：
2012-03-13
影响因子：
8.8
通讯作者：
Friedlander, M.
中科院分区：
文献类型：
--
作者：
Peate, M.;Meiser, B.;Friedlander, M.
背景：生育是许多年轻乳腺癌女性的首要任务。在化疗前，妇女需要了解保留生育能力的干预措施，以便做出高质量的决定。本研究旨在前瞻性地评估生育相关的决策援助（DA）的有效性。方法：共120例新诊断的早期乳腺癌患者来自19个澳大利亚肿瘤诊所，年龄在18-40岁，并希望未来的生育能力，进行了评估的决策冲突，知识，决策遗憾，生育相关的治疗决策和满意度。这些指标分别在基线、1个月和12个月进行测量，并采用线性混合效应模型进行检验。结果：与常规护理相比，接受DA的妇女决策冲突减少（β = -1.51; 95% CI：-2.54至0.48; P = 0.004）和改善的知识（β = 0.09; 95% CI：0.01-0.16; P = 0.02），调整教育、对孩子的渴望和基线不确定性后。在调整教育后，DA与1年时决策后悔减少相关（β = -3.73; 95% CI：-7.12至-0.35; P = 0.031）。接受DA的妇女对癌症治疗对生育能力影响的信息更满意（P
BACKGROUND: Fertility is a priority for many young women with breast cancer. Women need to be informed about interventions to retain fertility before chemotherapy so as to make good quality decisions. This study aimed to prospectively evaluate the efficacy of a fertility-related decision aid (DA).METHODS: A total of 120 newly diagnosed early-stage breast cancer patients from 19 Australian oncology clinics, aged 18-40 years and desired future fertility, were assessed on decisional conflict, knowledge, decision regret, and satisfaction about fertility-related treatment decisions. These were measured at baseline, 1 and 12 months, and were examined using linear mixed effects models.RESULTS: Compared with usual care, women who received the DA had reduced decisional conflict (beta = -1.51; 95% CI: -2.54 to 0.48; P = 0.004) and improved knowledge (beta = 0.09; 95% CI: 0.01-0.16; P = 0.02), after adjusting for education, desire for children and baseline uncertainty. The DA was associated with reduced decisional regret at 1 year (beta = -3.73; 95% CI: -7.12 to -0.35; P = 0.031), after adjusting for education. Women who received the DA were more satisfied with the information received on the impact of cancer treatment on fertility (P