Construction and evaluation of a decision-making process support model concerning treatment of breast cancer

本研究的目的是通过从患者和护士两个方向进行调查，阐明患者决策过程的实际状况，并在实际实践层面构建乳腺癌患者决策过程支持模型。研究结果如下：1。对19名乳腺癌患者进行了访谈，以阐明每一次经历的困难以及她与周围人的互动。困难的定义是，尽管他们的心理状态不稳定，但他们被迫做出决策：不确定和缺乏周围环境的支持，以及他们被生活的严重性和责任的重量所压倒的状态，使困难更加难以忍受。当明确了支持来源的角色特征及其局限性后，患者学会了适当地利用这种支持。为了阐明与更多决策相关的冲突程度以及影响决策的因素，我们试图在定性研究结果的基础上证明定量研究的可靠性。患者表现出中至高度的冲突，困难感表现出与定性研究结果相似的因素结构。冲突与心理恢复能力、满意度和积极态度呈负相关，提示了冲突的影响因素。该调查还对患者会承认的护理援助类型进行了调查。研究发现，护理行动不应局限于提供信息或提供情感帮助，而应是直接处理实际治疗选择的支持，如帮助加强决策作用。通过对护士的实际护理实践及相关困难的调查结果显示，心理支持不被认为是困难的，并且给予心理支持的频率较高。另一方面，服务，如提供针对每个病人的信息和支持鼓励与合作伙伴的互动，遇到了困难，因此较少实践，阐明了临床场景中存在的问题。对于未来的问题，认识到需要通过实际案例继续检查已构建的乳腺癌患者决策过程支持模型的适宜性，并通过介入研究对该模型进行评价。少

The purposes of this study are to conduct a survey from two directions-from patients and nurses-to elucidate the actual status of a decision-making process of patients and to make the decision-making process support model for breast cancer patients at the actual practice level. The results of the study are given below.1. Interviews were conducted with 19 patients who had breast cancer to elucidate the difficulty each experiences and her interactions with those around her. The difficulty was defined as decision-making forced on them in spite of their unstable psychological state: uncertainty and a lack of support from their surroundings, and a state in which they feel overwhelmed by the gravity of life and weight of the responsibility rendered the difficulty even more unbearable. When the characteristics of the role from the source of support and its limitations were clarified, the patient learned to utilize such support appropriately.2. To clarify the extent of conflict associated with … More decision-making and the factors affecting it, an attempt was made to prove the reliability of quantitative studies based on the results of qualitative research. The patient indicated a medium to high degree of conflict and the sense of difficulty showed a factor structure similar to the results from qualitative studies. Negative correlations were found between conflict and psychological capacity for recovery, satisfaction and a forward attitude, pointing to the factors that affect the conflict.3.The survey was conducted also on the type of nursing assistance that patients would acknowledge. It was found that nursing action should not be limited to offering information or giving emotional help : it should be the kind of support that deals directly with the actual therapeutic choice, such as help to reinforce the decision-making role. According to the results of survey conducted among nurses on actual nursing practice and associated difficulties, psychological support was not regarded as difficult and support was extended at a high frequency. On the other hand, services, such as providing information geared to each patient and support to encourage interactions with partners, encountered difficulty and therefore is practiced less frequently, elucidating problems that exist on the clinical scene.4.For future issues, needs were recognized for continued examination, through actual cases, of the appropriateness of the decision-making process support model for breast cancer patients that has been constructed, as well as evaluation of the model through interventional studies. Less