乳腺癌患者治疗决策影响因素的系统评价

Influencing factors in treatment decision-making for breast cancer patients: a systematic review

目的 系统评价乳腺癌患者治疗决策的影响因素。方法 计算机检索Web of Science、PubMed、EMbase、The Cochrane Library、JBI Evidence Synthesis、CINAHL、VIP、CBM、WanFang Data和CNKI数据库,搜集关于乳腺癌患者治疗决策影响因素的质性研究,检索时限均从建库至2021年10月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用汇集性整合法进行结果整合。结果 共纳入13个研究,提炼出67个结果,通过去重及合并后剩下22个结果,将相似结果归纳组合形成6个新类别,并综合成2个整合结果:患者参与治疗决策的影响因素和患者选择治疗方式的影响因素。结论 乳腺癌患者参与治疗决策不仅受到个人内在因素的影响,亦受到家庭及外部情境因素的影响。患者在选择治疗方式时不仅受个人偏好影响,亦会考虑治疗对家庭的影响及家人的期望,并受到来自社会环境层面的影响。

Objective To systematically review the influencing factors of breast cancer patients in treatment decision-making. Methods Web of Science, PubMed, EMbase, The Cochrane Library, JBI Evidence Synthesis, CINAHL,CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect qualitative studies about the influencing factors of breast cancer patients in treatment decision-making from inception to October 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then, the results were combined using integrating methods. Results A total of 13 studies were included. Sixty-seven results were extracted, with 22 results retained after incorporation and removal of duplications. The 22 results were grouped according to their similarities to form 6 categories. These categories resulted in two synthesized findings: influencing factors of patient participation in treatment decision-making and integration results and influencing factors of patients’ treatment options. Conclusion Breast cancer patient participation in treatment decisions is influenced not only by internal factors,but also by family and external situational factors. When patients choose treatment, they consider not only their personal values and preferences, but also the impact of treatment on their families and their expectations. The choice is also influenced by social and cultural aspects.