Social ecological influences on treatment decision-making in men diagnosed with low risk, localised prostate cancer.
Social ecological influences on treatment decision-making in men diagnosed with low risk, localised prostate cancer.
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DOI：
10.1111/ecc.13697
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发表时间：
2022-11
影响因子：
2.1
通讯作者：
Nelson, Christian
中科院分区：
文献类型：
--
作者：
McIntosh, Megan;Opozda, Melissa J.;Short, Camille E.;Galvao, Daniel A.;Tutino, Rebecca;Diefenbach, Michael;Ehdaie, Behfar;Nelson, Christian
关键词：
被诊断为低风险的局限性前列腺癌（PCa）患者面临着积极监测（AS）和确定性治疗之间的艰难决定。我们的目的是从患者和伴侣的角度探索对治疗决策的感知影响。招募符合AS标准并选择治疗的患者（及其伴侣）。通过电话进行半结构化个体访谈，以探索诊断经验、对患者生活方式的影响、与医生的经验、治疗偏好/选择、治疗信息理解和需求以及整体决策过程。访谈录音，逐字转录，并使用自反性主题分析进行分析。24名男性患者（18名选择AS）和12名女性伴侣参与了研究。确定了与治疗选择的社会生态影响有关的五个主题：（1）伴侣支持和对患者治疗选择的直接影响，（2）患者和伴侣的替代体验可能影响治疗决定，（3）患者生活环境的影响，（4）向更广泛的社交网络披露：朋友、家人和同事，以及（5）与医生保持良好关系和经验的重要性。此外，还确定了两个主题，涉及患者和伴侣在决策过程中收到的有关治疗方案的信息。报告了对治疗决策的一系列个人和社会影响。提供治疗建议的医生应考虑并讨论患者和伴侣的现有信念和治疗偏好，并鼓励共同决策。需要进一步研究伴侣和非伴侣PCa患者的治疗决策。我们建议研究考虑个人，人际，社区和政策层面的社会生态因素。
Individuals diagnosed with low risk, localised prostate cancer (PCa) face a difficult decision between active surveillance (AS) and definitive treatment. We aimed to explore perceived influences on treatment decision‐making from the patient and partner's perspectives. Patients (and partners) who met AS criteria and had chosen their treatment were recruited. Semi‐structured individual interviews were conducted via telephone to explore experiences of diagnosis, impact on patient lifestyle, experiences with physicians, treatment preferences/choice, treatment information understanding and needs, and overall decision‐making process. Interviews were audio recorded, transcribed verbatim, and analysed using Reflexive Thematic Analysis. Twenty‐four male patients (18 chose AS) and 12 female partners participated. Five themes relating to social‐ecological influences on treatment choice were identified: (1) partner support and direct influence on patient treatment choice, (2) patient and partner vicarious experiences may influence treatment decisions, (3) the influence of the patient's life circumstances, (4) disclosing to wider social networks: friends, family, and co‐workers, and (5) the importance of a good relationship and experience with physicians. Additionally, two themes were identified relating to information patients and partners received about the treatment options during their decision‐making process. A range of individual and social influences on treatment decision‐making were reported. Physicians providing treatment recommendations should consider and discuss the patient and partner's existing beliefs and treatment preferences and encourage shared decision‐making. Further research on treatment decision‐making of partnered and non‐partnered PCa patients is required. We recommend research considers social ecological factors across the personal, interpersonal, community, and policy levels.
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影响因子：
2.3
作者：
Kan CK;Qureshi MM;Gupta A;Agarwal A;Gignac GA;Bloch BN;Thoreson N;Hirsch AE
通讯作者：
Hirsch AE
影响因子：
3.7
作者：
Huber, Johannes;Muck, Tanja;Ihrig, Andreas
通讯作者：
Ihrig, Andreas
影响因子：
2.2
作者：
Mitchell, Jamie
通讯作者：
Mitchell, Jamie
DOI：
10.1016/s1078-1439(02)00209-0
发表时间：
2003-03-01
影响因子：
2.7
作者：
Berry, DL;Ellis, WJ;Yang, C
通讯作者：
Yang, C
影响因子：
254.7
作者：
DeSantis, Carol E.;Siegel, Rebecca L.;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin