背景:据说医生应在治疗方案信息方面为患者提供准确的证据。然而,在某些情况下,尽管医生提供了准确和充分的信息,患者仍然选择医学上不推荐的治疗方法。这项研究的目的是阐明当医生在提供有关癌症治疗的信息时改变解释框架时,患者的决定有何不同。
方法:2017年3月进行了在线问卷调查。通过一家调查公司的帮助,我们通过电子邮件向最近2年内接受治疗的1,360名癌症患者发送了问卷.我们将参与者随机分配到6种晚期癌症患者的假设情景中,并以不同的方式提出了假设的证据。随后,我们询问调查参与者是否会选择接受额外的抗癌治疗.
结果:尽管方案之间没有统计学上的显着差异,“社会负担”组显示,倾向于继续药物无效的抗癌治疗的患者比例低于对照组,10%的显著性水平。该情景显著影响患者的遗弃感[F(5,1,354)=5.680,P<0.001],痛苦感[F(5,1,354)=3.920,P=0.002],和改进的必要性[F(5,1,354)=2.783,P=0.017]。
结论:在考虑停止抗癌治疗的情况下,Nudges未显示有效。另一方面,一些轻推被发现是侵入性的,应该谨慎使用。
BACKGROUND: It has been said that physicians should provide their patients with accurate evidence in terms of information on treatment options. However, in some cases, although the physician provides accurate and sufficient information, the patient still chooses the medically not-recommended treatment. The purpose of this research is to clarify how patients\' decisions differ when a physician changes the frame of an explanation when he/she provides information about cancer treatment.
METHODS: An online questionnaire survey was conducted in March 2017. Through the aid of a survey company, we emailed questionnaires to 1,360 cancer patients who received treatment within the last 2 years. We randomly assigned participants to 6 hypotheticals scenario of a terminal cancer patient, and presented hypothetical evidence in different ways. Subsequently, we asked survey participants whether they would choose to receive additional anti-cancer treatment.
RESULTS: Although there was no statistically significant difference between scenarios, the \"social burden\" groups showed a lower rate of patients who preferred to continue a medically ineffective anti-cancer treatment than the control group, at a 10% significance level. The scenario significantly affected the patients\' sense of abandonment [F(5, 1,354)=5.680, P<0.001], sense of distress [F(5, 1,354)=3.920, P=0.002], and necessity of improvement [F(5, 1,354)=2.783, P=0.017].
CONCLUSIONS: Nudges were not shown to be effective in situations where discontinuation of anticancer treatment was being considered. On the other hand, some nudges were found to be invasive and should be used with caution.