晚期癌症患者参与治疗决策冲突的现状及影响因素分析

目的: 探讨晚期癌症患者参与治疗的决策冲突现状及影响因素,为制定晚期癌症患者参与治疗决策干预方案提供依据。方法: 采用便利抽样法,选取176例晚期癌症患者,使用患者决策冲突量表（DCS）调查患者的决策冲突现状,并进行单因素及多元回归分析其影响因素。结果: 176例有参与治疗决策意愿的患者决策冲突总分为（39.04±19.65）分,60.23%患者存在决策冲突（≥25分为存在决策冲突）,影响患者参与治疗决策冲突的独立影响因素包括：疾病分期、是否首次入院、患病时间（>3个月）及文化程度（小学及以下）（P<0.05）。结论: 多数患者存在决策冲突,受疾病分期、是否首次入院、患病时间及文化程度等多种因素综合影响。应进一步研制临床实用的决策辅助方案,有效的引导患者理性参与治疗决策中,满足患者对疾病信息的需求,从而降低患者决策冲突水平,提高其治疗依从性、决策满意度及生活质量。

The present situation and impact factors of decision conflict for the cancer treatment inadvanced cancer patients

Objective: To explore the present situation and impact factors decision conflict for the cancer treatment in advanced cancer patients,and to provide the basis for making intervention program. Methods: 176 patients with advanced cancer who were selected by convenience sampling were investigate the status of decision-making conflict using the patient decision conflict scale(DCS), and the influencing factors were analyzed by univariate and multiple regression. Results: The total score of DCS was 39.04±19.65, and 60.23% patients had treatment decision conflict. The independent influencing factors of decision conflict included: disease stage, first hospitalization, sick time(>3 months) and education level(primary and below)(P<0.05). Conclusion: Most patients have decision conflicts. It is suggested that further develop clinical and practical patient decision aids should be performed to effectively guide patients to participate in treatment decisions rationally, and to meet patients' needs for disease information, so as to reduce the level of patients' decision conflict, to improve their treatment compliance, decision satisfaction level and quality of life.