Abstract：
BACKGROUND: Many organizations recommend clinicians use structured communication processes, referred to as \"shared decision making,\" to improve patient-reported outcomes for patients considering lung cancer screening (LCS).
OBJECTIVE: Which components of high-quality patient-centered communication are associated with decision regret and distress?
METHODS: We conducted a prospective, longitudinal, repeated measures, cohort study among patients undergoing lung cancer screening in three different healthcare systems. We surveyed participants using validated measures of decision regret, decision satisfaction, distress, and patient-clinician communication domains up to a year after the low-dose computed tomography (LDCT) for LCS. For longitudinal analyses, we applied a series of generalized estimating equations to measure the association of the \"patient as person\" communication domain, screening knowledge, and decision concordance with decision regret and distress.
RESULTS: When assessed 2-4 weeks after the LDCT, 202 (58.9%) and 8 (2.3%) of 343 total respondents reported mild and moderate/severe decision regret, respectively, while 29 (9.2%) participants of 315 total reported mild distress and 19 (6.0%) moderate or greater distress. The mean ± SD decision satisfaction scores (0 to 10 scale) were 9.82 ± 0.89, 9.08 ± 1.54, and 6.13 ± 3.40 among those with no, mild, and moderate/severe regret respectively. Distress scores remained low after the LDCT, even among those with nodules. Patient-centered communication domains were not associated with decision regret or distress.
CONCLUSIONS: Patients undergoing LCS rarely experience moderate or greater decision regret and distress. Although many participants reported mild decision regret, most were very satisfied over the year after their LDCT for LCS. Communication processes were not associated with regret and distress, suggesting that it may be challenging for communication interventions to reduce the harms of LCS.
OBJECTIVE: Which components of high-quality patient-centered communication are associated with decision regret and distress?
METHODS: We conducted a prospective, longitudinal, repeated measures, cohort study among patients undergoing lung cancer screening in three different healthcare systems. We surveyed participants using validated measures of decision regret, decision satisfaction, distress, and patient-clinician communication domains up to a year after the low-dose computed tomography (LDCT) for LCS. For longitudinal analyses, we applied a series of generalized estimating equations to measure the association of the \"patient as person\" communication domain, screening knowledge, and decision concordance with decision regret and distress.
RESULTS: When assessed 2-4 weeks after the LDCT, 202 (58.9%) and 8 (2.3%) of 343 total respondents reported mild and moderate/severe decision regret, respectively, while 29 (9.2%) participants of 315 total reported mild distress and 19 (6.0%) moderate or greater distress. The mean ± SD decision satisfaction scores (0 to 10 scale) were 9.82 ± 0.89, 9.08 ± 1.54, and 6.13 ± 3.40 among those with no, mild, and moderate/severe regret respectively. Distress scores remained low after the LDCT, even among those with nodules. Patient-centered communication domains were not associated with decision regret or distress.
CONCLUSIONS: Patients undergoing LCS rarely experience moderate or greater decision regret and distress. Although many participants reported mild decision regret, most were very satisfied over the year after their LDCT for LCS. Communication processes were not associated with regret and distress, suggesting that it may be challenging for communication interventions to reduce the harms of LCS.
摘要：
背景：许多组织建议临床医生使用结构化的沟通流程，称为“共享决策”，“改善考虑肺癌筛查（LCS）的患者的患者报告结果。
目的：以患者为中心的高质量沟通的哪些组成部分与决策后悔和痛苦相关？
方法：我们进行了前瞻性，纵向,重复的措施,在三种不同的医疗保健系统中接受肺癌筛查的患者的队列研究。我们使用经过验证的决策遗憾衡量标准对参与者进行了调查，决策满意度，苦恼,以及LCS低剂量计算机断层扫描（LDCT）后长达一年的患者-临床医生交流领域。对于纵向分析，我们应用了一系列广义估计方程来测量“患者作为人”通信域的关联，筛选知识,以及决策与决策遗憾和痛苦的一致性。
结果：在LDCT后2-4周进行评估时，343名受访者中有202名（58.9％）和8名（2.3％）表示轻度和中度/重度决策遗憾，分别,而315名参与者中的29名(9.2%)参与者报告了轻度窘迫和19名(6.0%)中度或更严重的窘迫.无患者的平均±SD决策满意度得分（0至10分）分别为9.82±0.89、9.08±1.54和6.13±3.40，温和,分别为中度/重度后悔。LDCT后，窘迫评分仍然很低，即使是那些有结节的人。以患者为中心的沟通领域与决策遗憾或困扰无关。
结论：接受LCS的患者很少经历中度或更大的决策后悔和痛苦。尽管许多参与者报告了轻微的决定遗憾，大多数人在LCSLDCT后的一年里非常满意。沟通过程与遗憾和痛苦无关，这表明，沟通干预可能具有挑战性，以减少LCS的危害。
目的：以患者为中心的高质量沟通的哪些组成部分与决策后悔和痛苦相关？
方法：我们进行了前瞻性，纵向,重复的措施,在三种不同的医疗保健系统中接受肺癌筛查的患者的队列研究。我们使用经过验证的决策遗憾衡量标准对参与者进行了调查，决策满意度，苦恼,以及LCS低剂量计算机断层扫描（LDCT）后长达一年的患者-临床医生交流领域。对于纵向分析，我们应用了一系列广义估计方程来测量“患者作为人”通信域的关联，筛选知识,以及决策与决策遗憾和痛苦的一致性。
结果：在LDCT后2-4周进行评估时，343名受访者中有202名（58.9％）和8名（2.3％）表示轻度和中度/重度决策遗憾，分别,而315名参与者中的29名(9.2%)参与者报告了轻度窘迫和19名(6.0%)中度或更严重的窘迫.无患者的平均±SD决策满意度得分（0至10分）分别为9.82±0.89、9.08±1.54和6.13±3.40，温和,分别为中度/重度后悔。LDCT后，窘迫评分仍然很低，即使是那些有结节的人。以患者为中心的沟通领域与决策遗憾或困扰无关。
结论：接受LCS的患者很少经历中度或更大的决策后悔和痛苦。尽管许多参与者报告了轻微的决定遗憾，大多数人在LCSLDCT后的一年里非常满意。沟通过程与遗憾和痛苦无关，这表明，沟通干预可能具有挑战性，以减少LCS的危害。
