晚期癌症病人治疗决策困境现状及影响因素研究

The status and influencing factors of treatment decision dilemma in patients with advanced cancer

目的:调查晚期癌症病人治疗决策困境现状并分析其影响因素,为提高晚期癌症病人临床决策参与率提供参考依据。方法:采用便利抽样法,选择住院治疗的晚期癌症病人共286例,采用一般资料调查表、病人权力距离量表、决策困境量表进行横断面调查。结果:286例晚期癌症病人决策困境量表得分为(44.29±7.77)分,81.82%的病人存在决策拖延;病人婚姻状况、文化程度、职业、个人月收入、医保情况、癌症来源和权力距离是病人决策困境的影响因素(P<0.05)。结论:晚期癌症病人普遍存在决策困境;临床工作应重视评估晚期癌症病人决策困境情况,准确评估及早干预,有效提升医护患沟通质量,提高病人参与意愿,维护病人安全。

Objective:To investigate the status of treatment decision dilemma in patients with advanced cancer,and analyze its influencing factors,so as to provide reference and basis for improving the clinical decision participation rate of patients with advanced cancer.Methods:A total of 286 patients with advanced cancer who were hospitalized in a Class A tertiary hospital in Tianjin from June to September 2022 were included by convenience sampling.The general information questionnaire,patient power distance scale and decision dilemma scale were used to conduct a cross-sectional survey.Results:The total score of decision dilemma was 44.29±7.77,and 81.82%of patients had decision delay.Patients′marriage,education background,occupation,personal monthly income,medical insurance status,disease type,and the power distance were the influencing factors of patients′decision dilemma(P<0.05).Conclusion:The decision dilemma of patients with advanced cancer is common.Clinical work should pay attention to the assessment of the decision dilemma and make targeted interventions to effectively improve the quality of doctor-patient communication,improve the willingness of patients to participate,and maintain patients safety.