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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Adolescent and Young Adult Cancer Patients' Experiences With Treatment Decision-making
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Adolescent and Young Adult Cancer Patients' Experiences With Treatment Decision-making

机译：青少年和年轻成人癌症患者的治疗决策经验

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This study surveyed 203 AYAs with newly diagnosed cancer to evaluate decision-making preferences, decisional engagement, and regret. BACKGROUND:Adolescents and young adults (AYAs) with cancer generally want to engage in decision-making but are not always able to do so. We evaluated cancer treatment decision-making among AYAs, including decisional engagement and regret.METHODS:We surveyed 203 AYA patients with cancer aged 15 to 29 (response rate 74%) treated at a large academic center and their oncologists. Patients were approached within 6 weeks of diagnosis and asked to report decision-making preferences and experiences (Decisional Roles Scale) and the extent to which they regretted their initial treatment decision (Decisional Regret Scale) assessed at baseline and 4 and 12 months later.RESULTS:A majority of AYAs (58%) wanted to share responsibility for decision-making with oncologists; half (51%) preferred limited involvement from parents. Although most AYAs held roles they preferred, those who did not reported holding more passive roles relative to oncologists (P < .0001) and parents (P = .002) than they desired. Nearly one-quarter of patients (24%; 47 of 195) experienced regret about initial cancer treatment decisions at baseline, with similar rates at 4 (23%) and 12 (19%) months. In a multivariable model adjusted for age, decisional roles were not associated with regret; instead, regret was less likely among patients who trusted oncologists completely (odds ratio 0.17 [95% confidence interval 0.06-0.46]; P < .001) and who reported that oncologists understood what was important to them when treatment started (odds ratio 0.13 [95% confidence interval 0.04-0.42]; P < .001).CONCLUSIONS:Nearly one-fourth of AYA patients expressed regret about initial treatment decisions. Although some AYAs have unmet needs for decisional engagement, attributes of the patient-oncologist relationship, including trust and mutual understanding, may be most protective against regret.
机译：这项研究调查了203个阿亚斯新诊断癌症的评估决策偏好，决策参与，而遗憾。背景：青少年和年轻成人（阿亚斯）与癌症一般要参与决策，但并不总是能够这样做。我们评估阿亚斯中癌症治疗决策，包括决策参与和regret.METHODS：我们调查了203名AYA患者在一家大型学术中心和他们的肿瘤科医生治疗的癌症15至29岁（应答率74％）。患者6周诊断的范围内搭讪，问到报告的决策偏好和经验（判决角色量表），以及他们后悔自己最初的治疗决定（判决后悔量表）在基线和4和12个月later.RESULTS评估了：阿亚斯（58％）的大多数想为决策与肿瘤科医生共同负责;一半（51％），优选从父母有限的参与。虽然大多数阿亚斯举行的角色，他们首选，这些谁没有报道持相对比他们期望的肿瘤学家（P <0.0001）和父母（P = 0.002）比较被动的角色。患者的近四分之一（24％; 195 47）约在基线初始癌症治疗决策经验的遗憾，类似的利率在4（23％）和12（19％）个月。在调整了年龄一个多变量模型，决策角色并不遗憾关联;相反，遗憾的是不太可能谁可以完全信赖的肿瘤学家（比值比0.17区间0.06-0.46 95％]; P <.001）的患者中，谁报告说，肿瘤学家明白了什么是对他们最重要时开始治疗（比值比为0.13 95％置信区间0.04-0.42; P <0.001）。结论：近四分之一表示对初始治疗决定遗憾AYA患者。虽然有些阿亚斯具有决策参与未满足的需求，属性患者肿瘤学家关系，包括信任和相互理解的，可能是最具保护性的抗遗憾。

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