已经对选择主动监测(AS)的低风险前列腺癌(PCa)男性的生活质量(QoL)进行了多项研究。虽然最近的评论显示现有的QoL研究缺乏一致性,已经确定了几个关键点,包括与决策(DM)相关的问题及其对QoL的潜在影响。欧洲肿瘤学学院的国际工作队最近也强调了这一主题的重要性。然而,根据我们的知识,在接受AS的低风险PCa的男性中,没有专门收集有关DM和QoL之间关联的科学知识的研究.我们进行了文献综述来填补这一空白,采取系统的方法来检索和选择包括DM和QoL措施的文章。在检索到的272篇文章中,我们选择了九个观测,同时使用DM和QoL度量的定量文章。这些研究中考虑最多的DM方面是决定冲突和患者在DM过程中的角色偏好,以及与健康相关的QoL方面。这些研究包括42项关于DM经验测量与QoL经验测量之间关系的评估。在这些评估中,23(55%)均为阳性且显著。他们主要关注与患者相关的关系(决策自我效能感,决策控制和知识)和外部(社会支持的存在,DM流程中的协作角色,以及不同医生的影响)DM方面,以及选择后的QoL。这些研究的结果揭示了AS中与DM和QoL相关的研究和临床实践的关键挑战。这些包括采用以人为本的观点,临床医生,护理人员及其相互作用也包括在评估中,并考虑了DM和AS旅程中个体的心理社会存在经验.诊断后需要更多地关注DM过程,以及患者可能不得不或想要审查他们的决定的所有其他时刻。医疗保健专业人员在使男性做出明智的决定并在AS期间照顾他们的健康和福祉方面发挥着关键作用。在培训来自不同学科的医疗保健专业人员以在针对低风险PCa患者及其家庭成员的需求的共享DM和AS模型中合作方面,仍然需要做工作。
Several studies have been conducted on the quality of life (QoL) in men with low risk prostate cancer (PCa) who choose active surveillance (AS). While recent reviews have shown a lack of consistency among the available QoL-studies, a few key points have been identified, including decision-making (DM)-related issues and their potential effect on QoL. The importance of this theme has also been recently highlighted by the international task force of the European School of Oncology. However, to our knowledge, there are no studies that have specifically marshalled scientific knowledge on the association between DM and QoL among men with low-risk PCa undergoing AS. We performed a literature
review to fill this gap, taking a systematic approach to retrieving and selecting articles that included both DM and QoL measures. Among the 272 articles retrieved, we selected nine observational, quantitative articles with both DM and QoL measures. The most considered DM aspects within these studies were decisional conflict and preference for the patient\'s role in the DM process, as well as health-related QoL aspects. The studies included 42 assessments of the relationship between an empirical measure of DM and an empirical measure of QoL. Among these assessments, 23 (55%) were both positive and significant. They mostly concerned the relationship between patient-related (decisional self-efficacy, decisional control and knowledge) and external (presence of social support, collaborative role within the DM process, and influence of different physicians) DM aspects, as well as the QoL after choice. The findings of these studies revealed key challenges to research and clinical practice related to DM and QoL in AS. These include adopting a person-centred perspective where clinicians, caregivers and their interactions are also included in evaluations and where the psychosocial existential experience of individuals within the DM and AS journey is considered. Much more attention needs to be paid to the DM process after diagnosis, as well as to all the other moments where patients may have to or want to
review their decision. Healthcare professionals play a key role in enabling men to make informed decisions and to take care of their health and well-being during AS. There is still work that needs to be done in training healthcare professionals from different disciplines to work together in a model of shared DM and AS tailored to the needs of low-risk PCa patients and their family members.