术前共同决策在乳腺癌手术治疗患者中的应用

Application of preoperative shared decision-making in patients with breast cancer surgery

目的探究与分析术前共同决策在乳腺癌手术治疗患者中的应用。方法选取我院自2018年4月~2021年5月收治的乳腺癌手术患者110例,按照就诊时间顺序分为对照组(2018年4月~2020年3月),共54例;观察组(2020年4月~2021年5月),共56例。对照组给予常规术前干预,观察组在对照组基础上给予术前共同决策干预,对比两组患者入院时及术前1 d的决策困境量表(Decision Conflict Scale,DCS)评分、决策准备量表(Decision Making,DM)评分及决策后悔量表(Diagnostic Reading Scales,DRS)评分;对比干预前、干预后1个月、3个月医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)评分,同时观察两组患者对不同术前干预方法的满意度。结果两组术前1 d与入院时相比,DCS评分较低、DM评分较高、DRS评分较低;观察组术前1 d与对照组术前1 d比较,DCS评分较低、DM评分较高、DRS评分较低,差异有统计学意义(P<0.05)。两组干预后1个月、3个月分别与干预前比较,焦虑水平、抑郁水平评分均较低;干预后3个月与干预后1个月比较,焦虑水平、抑郁水平评分均较低;观察组干预后1个月、干预后3个月分别与对照组干预后1个月、干预后3个月比较,焦虑水平、抑郁水平评分较低,差异有统计学意义(P<0.05)。观察组与对照组比较,患者对术前干预方法的满意度较高,差异有统计学意义(P<0.05)。结论术前共同决策应用在乳腺癌手术过程中可明显改善患者焦虑抑郁情绪,对患者的临床决策可产生较强的促进作用,同时也提高了其决策准备度,明显地提升了患者对术前干预的满意度。

Objective To explore and analyze the application of preoperative shared decision-making in patients with breast cancer surgery. Methods A total of 110 patients with breast cancer admitted to our hospital from April 2018 to May 2021 were selected. According to the order of treatment time, they were divided into the control group(April 2018 to March 2020), with a total of 54 cases, and observation group(April 2020 to May 2021), with a total of 56 cases. The control group was given routine preoperative intervention, and the observation group was given preoperative shared decision-making intervention on the basis of the control group. Dilemma Scale(DCS) score, Decision Readiness Scale(DM) score and Decision Regret Scale(DRS) score of the two groups of patients were compared at admission and 1 day before surgery;the Hospital Anxiety and Depression Scale(HADS) scores before the intervention, 1 month after the intervention, and 3 months after the intervention were compared. The satisfaction of the two groups of patients with different preoperative intervention methods were compared. Results The two groups had lower DCS scores, higher DM scores, and lower DRS scores 1 day before surgery compared with the time of admission. Compared with the control group, the observation group had lower DCS scores, higher DM scores, lower DRS score, and the differences were statistically significant(P<0.05). The anxiety and depression scores of the two groups were lower than those before the intervention at 1 month and 3 months after the intervention, and the anxiety and depression scores were lower at 3 months after the intervention and 1 month after the intervention(P<0.05). The anxiety and depression scores of the observation group were lower than those of the control group at 1 month and 3 months after intervention, respectively, and the differences were statistically significant(P<0.05). Compared with the control group, the observation group was more satisfied with the preoperative intervention methods, and the difference was statistically significant(P<0.05). Conclusion The application of preoperative shared decision-making during breast cancer surgery can significantly improve the anxiety and depression of patients, and can have a strong promotion effect on patients’ clinical decision-making. At the same time, it also improve the patients’ decision-making readiness, and degree of satisfaction with preoperative intervention.