川西高原地区恶性肿瘤患者的放、化疗决策及影响因素的研究

Study on the Influencing Factors for Chemoradiotherapy Decision-making of Tibetan Patients with Malignant Tumor

目的 初步探讨四川川西地区恶性肿瘤患者抗肿瘤治疗的影响因素,以指导临床工作。方法 采用问卷调查及访谈的方式,调查2018-2021年某医院176名川西地区恶性肿瘤患者及家属放、化疗决策及影响因素。结果 分期和宗教信仰是川西地区恶性肿瘤患者放化疗决策的独立影响因素,在控制其他影响因素后,Ⅰ-Ⅲ期患者接受规定放化疗的可能性是Ⅳ期患者的2.77倍,有宗教信仰的患者接受规定放化疗的可能性是没有宗教信仰患者的0.13倍;绝大多数家庭都是家属部分或完全参与治疗决策。结论 医务人员在面对川西地区恶性肿瘤患者时要充分了解并尊重其文化和宗教背景,鼓励患者积极参与到共同决策中,尽量由藏汉语双通的医务人员进行沟通,让患者充分理解治疗的意义及效果,以提高临床治疗效果。

Objective To explore the influencing factors of antitumor treatment for Tibetan patients with malignant tumors in Sichuan,so as to provide guidance for clinical diagnosis and treatment.Methods Questionnaire and interview were used to investigate the anti-tumor methods of 181 Tibetan malignant tumor patients and their families in a hospital from 2016 to 2018,and to study the influencing factors of clinical decision-making.Results Neoplasm stage and religious were the independent influencing factors of Tibetan patients′chemoradiotherapy decision-making.After controlling other influencing factors,patients with stage I-III were 2.77 times more likely to receive prescribed chemoradiotherapy than patients with stage IV,and patients with religious were 0.13 times more likely to receive prescribed chemoradiotherapy than patients without religious belief;More than half of the patients did not fully know their condition,and most families were family members who partially or completely participated in the treatment decision-making.Conclusions When facing Tibetan patients,medical staff should fully understand and respect their cultural and religious background,encourage patients to actively participate in decision-making,and the doctor-patient communication should be implemented by medical staff with both Tibetan and Chinese.Popular e language should be used in communication to make sure that patients can fully understand the significance and effect of treatment,so as to improve clinical effect.