Physicians' decision-making style and psychosocial outcomes among cancer survivors.
Physicians' decision-making style and psychosocial outcomes among cancer survivors.
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DOI：
10.1016/j.pec.2009.10.004
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发表时间：
2009-12
影响因子：
3.5
通讯作者：
Potosky, Arnold L.
中科院分区：
文献类型：
--
作者：
Arora, Neeraj K.;Weaver, Kathryn E.;Clayman, Marla L.;Oakley-Girvan, Ingrid;Potosky, Arnold L.
关键词：
我们评估了医生的决策方式与癌症幸存者的健康相关生活质量（HRQOL）之间的联系。我们分析了研究前2-5年在北方加州诊断为白血病、结直肠癌或膀胱癌的623名幸存者的调查数据。其中，395人报告在过去12个月内做出了医疗决定，并被问及他们的医生的决策风格。我们评估了医生风格与近端沟通结果（信任，参与自我效能），中间认知结果（感知控制，不确定性）和远端健康结果（身体和精神HRQOL）的关联。总体而言，54%的幸存者报告了他们的医生的次优决策风格。除身体健康外，医生风格与所有近端、中间和远端结局相关（p≤0.01）。我们确定了参与式医生风格可能与幸存者心理健康相关的两个重要途径：1）通过提高幸存者的参与自我效能，从而增强他们对个人控制的感知（p<0.01）; 2）通过提高幸存者的信任水平，从而降低他们对不确定性的感知（p<0.05）。参与式医生风格可以通过改善幸存者的近端沟通和中间认知结果的复杂两步机制来改善幸存者的心理健康。采用参与式决策风格的医生可能会促进患者赋权并提高患者的HRQOL。
We evaluated pathways linking physicians' decision-making style with cancer survivors' health-related quality of life (HRQOL) We analyzed survey data from 623 survivors diagnosed with leukemia, colorectal, or bladder cancer in Northern California, 2–5 years prior to the study. Of these, 395 reported making a medical decision in the past 12 months and were asked about their physician's decision-making style. We evaluated the association of physician style with proximal communication outcomes (trust, participation self-efficacy), intermediate cognitive outcomes (perceived control, uncertainty), and distal health outcomes (physical and mental HRQOL). Overall, 54% of survivors reported a sub-optimal decision-making style for their physician. With the exception of physical health, physician style was associated with all proximal, intermediate, and distal outcomes (p≤0.01). We identified two significant pathways by which a participatory physician style may be associated with survivors' mental health: 1) by increasing survivors' participation self-efficacy and thereby enhancing their perceptions of personal control (p<0.01); 2) by enhancing survivors' level of trust and thereby reducing their perceptions of uncertainty (p<0.05). A participatory physician style may improve survivors' mental health by a complex two step mechanism of improving survivors' proximal communication and intermediate cognitive outcomes. Physicians who adopt a participatory decision-making style are likely to facilitate patient empowerment and enhance patients' HRQOL.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
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影响因子：
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作者：
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影响因子：
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Levinson, W
影响因子：
7.2
作者：
DEGNER, LF;SLOAN, JA
通讯作者：
SLOAN, JA