{"title":"构建并应用决策支持工具，以确定乳腺癌化疗患者的静脉通路。","authors":"Meng Wu, Yan-Yan Liao, Zheng Lin","doi":"10.1111/jep.14152","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To construct a decision support tool for determining venous access in chemotherapy of breast cancer.</p><p><strong>Methods: </strong>A decision support tool for determining venous access was developed through semi-structured interviews, literature analysis, expert inquiry, and user adaptation. The subjects of the study were breast cancer patients with chemotherapy who planned to have deep vein catheterization in a Grade IIIA hospital in Nanjing from August to December 2023. The enrolled patients were then divided into the control group and the intervention group, with 44 cases in each group. The control group received routine pre-catheterization interviews, while the intervention group used the decision support tool on this basis. Further comparison was conducted on the willingness of and actual participation in decision-making, decisional conflict, decision-making satisfaction, and decision regret between the two groups using t-test and chi-square test.</p><p><strong>Results: </strong>This study constructed a decision support tool for determining venous access in chemotherapy of breast cancer, including 8 primary indicators and 40 secondary indicators. The intervention group actually participated in treatment decisions more than the control group, and the intervention group was more willing to participate in treatment decisions (p < 0.05). Furthermore, the intervention group had significantly higher degrees of actual participation in decision-making and satisfaction with decision-making compared to the control group (p < 0.05); while the former group had significantly lower decisional conflict, decision regret at 1 month and 3 months after discharge than those in the latter group (p < 0.05).</p><p><strong>Conclusion: </strong>The decision support tool for determining venous access in chemotherapy of breast cancer is scientific and practical to promote patient participation in decision-making, reduce decisional conflicts, improve decision-making quality, and achieve joint decision-making between doctors and patients.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Construction and application of a decision support tool for determining venous access in breast cancer chemotherapy patients.\",\"authors\":\"Meng Wu, Yan-Yan Liao, Zheng Lin\",\"doi\":\"10.1111/jep.14152\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To construct a decision support tool for determining venous access in chemotherapy of breast cancer.</p><p><strong>Methods: </strong>A decision support tool for determining venous access was developed through semi-structured interviews, literature analysis, expert inquiry, and user adaptation. The subjects of the study were breast cancer patients with chemotherapy who planned to have deep vein catheterization in a Grade IIIA hospital in Nanjing from August to December 2023. The enrolled patients were then divided into the control group and the intervention group, with 44 cases in each group. The control group received routine pre-catheterization interviews, while the intervention group used the decision support tool on this basis. Further comparison was conducted on the willingness of and actual participation in decision-making, decisional conflict, decision-making satisfaction, and decision regret between the two groups using t-test and chi-square test.</p><p><strong>Results: </strong>This study constructed a decision support tool for determining venous access in chemotherapy of breast cancer, including 8 primary indicators and 40 secondary indicators. The intervention group actually participated in treatment decisions more than the control group, and the intervention group was more willing to participate in treatment decisions (p < 0.05). Furthermore, the intervention group had significantly higher degrees of actual participation in decision-making and satisfaction with decision-making compared to the control group (p < 0.05); while the former group had significantly lower decisional conflict, decision regret at 1 month and 3 months after discharge than those in the latter group (p < 0.05).</p><p><strong>Conclusion: </strong>The decision support tool for determining venous access in chemotherapy of breast cancer is scientific and practical to promote patient participation in decision-making, reduce decisional conflicts, improve decision-making quality, and achieve joint decision-making between doctors and patients.</p>\",\"PeriodicalId\":15997,\"journal\":{\"name\":\"Journal of evaluation in clinical practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of evaluation in clinical practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jep.14152\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of evaluation in clinical practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jep.14152","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
目的方法：通过半结构式访谈、文献分析、专家咨询和用户调整，开发出一种用于确定乳腺癌化疗静脉通路的决策支持工具：方法：通过半结构式访谈、文献分析、专家询问和用户适应性调整，开发了确定静脉通路的决策支持工具。研究对象为2023年8月至12月期间计划在南京一家三级甲等医院接受深静脉导管置入术的乳腺癌化疗患者。入组患者被分为对照组和干预组，每组44例。对照组接受常规导管术前访谈，干预组在此基础上使用决策支持工具。采用 t 检验和卡方检验对两组患者的决策意愿和实际参与情况、决策冲突、决策满意度和决策后悔度进行了进一步比较：本研究构建了乳腺癌化疗中确定静脉通路的决策支持工具，包括 8 个一级指标和 40 个二级指标。干预组实际参与治疗决策的程度高于对照组，干预组更愿意参与治疗决策（P乳腺癌化疗静脉通路决策支持工具具有科学性和实用性，可促进患者参与决策，减少决策冲突，提高决策质量，实现医患共同决策。
Construction and application of a decision support tool for determining venous access in breast cancer chemotherapy patients.
Objective: To construct a decision support tool for determining venous access in chemotherapy of breast cancer.
Methods: A decision support tool for determining venous access was developed through semi-structured interviews, literature analysis, expert inquiry, and user adaptation. The subjects of the study were breast cancer patients with chemotherapy who planned to have deep vein catheterization in a Grade IIIA hospital in Nanjing from August to December 2023. The enrolled patients were then divided into the control group and the intervention group, with 44 cases in each group. The control group received routine pre-catheterization interviews, while the intervention group used the decision support tool on this basis. Further comparison was conducted on the willingness of and actual participation in decision-making, decisional conflict, decision-making satisfaction, and decision regret between the two groups using t-test and chi-square test.
Results: This study constructed a decision support tool for determining venous access in chemotherapy of breast cancer, including 8 primary indicators and 40 secondary indicators. The intervention group actually participated in treatment decisions more than the control group, and the intervention group was more willing to participate in treatment decisions (p < 0.05). Furthermore, the intervention group had significantly higher degrees of actual participation in decision-making and satisfaction with decision-making compared to the control group (p < 0.05); while the former group had significantly lower decisional conflict, decision regret at 1 month and 3 months after discharge than those in the latter group (p < 0.05).
Conclusion: The decision support tool for determining venous access in chemotherapy of breast cancer is scientific and practical to promote patient participation in decision-making, reduce decisional conflicts, improve decision-making quality, and achieve joint decision-making between doctors and patients.
期刊介绍：
The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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