早期非小细胞肺癌患者参与手术决策现状调查及影响因素

Investigation on the Current Situation and Influencing Factors of Patients with Early Stage Non-small Cell Lung Cancer Participating in Surgery Decision-making

目的:调查早期非小细胞肺癌患者参与手术治决策的期待、现状及影响因素。方法:用决策期待量表调查144例早期非小细胞肺癌患者参与决策现状,采用Logistic回归分析其参与决策的影响因素。结果:患者期待与实际参与手术治疗方式均为被动型占主导,治疗过程中患者期待与家属共同参与,主要与性别、性格、受教育程度、婚姻、病程、学历、付费方式、子女数有关。结论:早期非小细胞肺癌患者期待与实际参与手术决策及期待家属与家属实际参与程度之间均有统计学差异(P<0.01)。内向性格的患者期待被动参与,外向性格、受教育程度越高表现为合作型;职工医保的患者实际参与类型为主动型和合作型;子女数越多,参与方式越被动;已婚患者比较倾向于除家属全权代表的其他参与类型。子女数越少的患者期待家属合作型,反之期待家属主导型;内向性格患者期待主动型;而实际上家属在整个决策中为主导者。根据不同人格特质的患者,提供针对性指导,鼓励患者参与医疗安全。

Objective:To investigate the expectation,status and influencing factors of patients with early stage non-small cell lung cancer(NSCLC)participating in surgery decision making.Methods:Decision expectation scale was used to investigate the current situation of decision making in 144 patients with early stage NSCLC,and Logistic regression was used to analyze the influencing factors of decision making.Results:Patients′expectation and actual participation in surgical treatment were dominated by passive type,and patients′expectation to participate in the treatment with their family members was mainly related to gender,personality,education level,marriage,disease course,educational background,payment method and number of children.Conclusion:There were statistically significant differences between expectation and actual participation in surgery decision-making and between expectation and actual participation of family members in patients with early stage NSCLC(P<0.01).Introverted patients expected passive participation,and the extroverted and the more educated were more cooperative.The actual participation type of patients with medical insurance for employees was initiative type and cooperative type.The greater number of children was with the more passive mode of participation.Married patients were more likely to participate in other types than family plenipotentiaries.Patients with fewer children expected family members to cooperate,while those with more children expected family members to lead.Introverted patients expected initiative.In fact,family members played a leading role in the whole decision.According to different personality characteristics of patients,we should provide targeted guidance and encourage patients to participate in medical safety.