目的:评估患者和医疗保健专业人员在原发性乳腺癌辅助系统治疗共同决策中的信息和沟通重点,并据此确定关键决策相关信息。
方法:患者(N=122)和与乳腺癌患者一起工作的专业人员(N=118),其中38名是执业护士和32名护士,是使用便利抽样招募的,并调查了对决策至关重要的信息/通信方面,使用排名作业。我们进一步提出了一个简单的开放性问题,关于接收基于人群的统计数据与关于治疗结果的个性化统计数据的问题,以及他们对共同决策的态度和经验。使用描述性分析和定性分析对数据进行分析。
结果:患者和专业人员都优先考虑有关治疗结果的信息(即,生存,复发)作为患者的关键决策相关信息。患者优先考虑有关相对严重的治疗副作用和晚期影响的信息(例如,血块,stroke),而专业人员优先考虑相对经常发生的影响的信息(例如,脱发,疲劳)。患者特别想知道治疗的好处是否值得负面影响。两组都将个性化统计数据优先于基于人口的统计数据。
结论:患者和专业人员之间在信息和沟通优先级方面存在一些差异,特别与不同的副作用有关。在有关辅助系统治疗的共同决策中,精确解决这些副作用似乎值得。此外,如果治疗的预期益处值得对个体患者产生潜在的负面影响,那么共同思考这个问题似乎很重要.
OBJECTIVE: To assess information and communication priorities of patients and healthcare professionals in Shared Decision Making about adjuvant systemic treatment of primary breast cancer and identify key decision-relevant information accordingly.
METHODS: Patients (N = 122) and professionals working with breast cancer patients (N = 118), of whom 38 were nurse practitioners and 32 nurses, were recruited using convenience sampling, and surveyed about information/communication aspects key to decision-making, using ranking assignments. We further posed a simple open question, questions about receiving population-based statistics versus personalized statistics concerning treatment outcomes, and their attitude and experience concerning Shared Decision Making. Data were analyzed using descriptive analysis and a qualitative analysis.
RESULTS: Both patients and professionals prioritized information about treatment outcomes (i.e., survival, recurrence) as key decision-relevant information for patients. Patients prioritized information about relatively severe treatment side-effects and late effects (e.g., blood clot, stroke), whilst professionals prioritized information about effects that occur relatively often (e.g., hair loss, fatigue). Patients specifically wanted to know if the benefit of treatment is worth the negative impact. Both groups prioritized personalized statistics over population-based statistics.
CONCLUSIONS: Some differences between patients and professionals were found in information and communication priorities, specifically related to the different side-effects. It seems worthwhile to precisely address these side-effects in Shared Decision Making concerning adjuvant systemic treatment. Furthermore, it seems important to deliberate together on the question if expected benefit of treatment is worth the potential negative impact for the individual patient.