题名

乳癌病人使用智慧型手機應用程式輔助手術決策

并列篇名

Smartphone-Application Assisted Surgery Decision among Breast Cancer Patients

DOI

10.6320/FJM.202203_26(2).0003

作者

莊佳雯(Chia-Wen Chuang);吳世重(Shih-Chung Wu);莊情惠(Chin-Hui Chuang);李芸芳(Yun-Fang Lee);周娟羽(Chuan-Yu Chou);黃芷苓(Chih-Ling Huang)

关键词

智慧型手機應用程式 ; 早期乳癌 ; 手術决策 ; smartphone apps ; early breast cancer ; surgical decision making

期刊名称

台灣醫學

卷期/出版年月

26卷2期(2022 / 03 / 25)

页次

150 - 158

内容语文

繁體中文

中文摘要

早期乳癌病患面對手術決策過程,常遇到決策困難,資訊應用在醫療决策上,已經是常見的輔助系統。本研究目的為設計智慧型手機應用程式,做為早期乳癌病之手術決策輔助工具,並且探索乳癌病患使用之經驗歷程,於2019年8至12月共招募10位早期乳癌病患,參與本質性研究,使用半結構式指引與錄音的方式進行訪談,研究結果發現病患進行決策過程,由三個主題組成:(一)產生認知-理解相關訊息;(二)決策支持-了解自己及家人的想法;(三)為自己做決定-增加決策信心、確定選擇與降低決策過程的焦慮。智慧型手機行動應用程式輔助乳癌患者手術决策,對於疾病的認知、支持病患決策與釐清病患的價值觀與偏好有正向的影響,但康復期之病患,是否會發生決策反悔,建議未來研究應持續追蹤,才能確認長期的決策成效。

英文摘要

Early-stage breast cancer patients have difficulty in decision as they face the choice of surgery methods. The smartphone application is already a common system to support patients in medical decision-making. The purpose of the study is to explore the decision process of surgery assisted by smartphone-application among breast cancer patients. Ten early-stage breast cancer patients were recruited between August and December 2019 and participated in this qualitative study. A semi-structured guideline was applied and interviews were tape recorded for subsequent verbatim transcription. The core experience of patients was the decision process. The context composed of three themes: (1) to improve the cognition - to understand relevant information; (2) to support decision - to understand their own and families' opinions; (3) to make one's own decision - to increase decision confidence, to sure the choice, and to reduce anxiety in the decision process. The results revealed positive impacts on the promotion of the disease knowledge, supporting patients' surgical decision-making, and clarifying the patients' values and preferences by using smartphone application to assist patients' choices of surgeries. For further study, the long-term effects should be explored by follow breast cancer survivors' regret in their decision.

主题分类 醫藥衛生 > 醫藥衛生綜合
参考文献
  1. Moiel D, Thompson J, Larsen KD. Mastectomy or breast-conserving therapy: Which factors influence a patient's decision? Perm J 2019;23:18-049.
    連結:
  2. Lim JW, Shon EJ. Decisional conflict: Relationships between and among family context variables in cancer survivors. Oncol Nurs Forum 2016;43:480-8.
    連結:
  3. Stacey D, Légaré F, Lewis K, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2017;4:CD001431.
    連結:
  4. Sondergaard SR, Madsen PH, Hilberg O, et al. A prospective cohort study of shared decision making in lung cancer diagnostics: Impact of using a patient decision aid. Patient Educ Couns 2019;102:1961-8.
    連結:
  5. Lu C, Li X, Yang K. Trends in Shared Decision-Making Studies From 2009 to 2018: A Bibliometric Analysis. Front Public Health 2019;7:384.
    連結:
  6. Litière S, Werutsky G, Fentiman IS, et al. Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol 2012;13:412-9.
    連結:
  7. Zehra S, Doyle F, Barry M, et al. Health-related quality of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: A systematic review and meta-analysis. Breast Cancer 2020;27:534-66.
    連結:
  8. Yamauchi K, Nakao M, Nakashima M. Correlates of regret with treatment decision-making among Japanese women with breast cancer: Results of an internet-based cross-sectional survey. BMC Womens Health 2019;19:86.
    連結:
  9. Elwyn G, Frosch D, Rollnick S. Dual equipoise shared decision making: Definitions for decision and behaviour support interventions. Implem Sci 2009;4:75.
    連結:
  10. de Mik SML, Stubenrouch FE, Balm R, et al. Systematic review of shared decision-making in surgery. Br J Surg 2018;105:1721-30.
    連結:
  11. Pablos JL, Jover JA, Roman-Ivorra JA, et al. Patient decision aid (PDA) for patients with rheumatoid arthritis reduces decisional conflict and improves readiness for treatment decision making. Patient 2020;13:57-69.
    連結:
  12. Si J, Guo R, Lu X, et al. Decision aids on breast conserving surgery for early stage breast cancer patients: A systematic review. BMC Med Inform Decis Mak 2020;20:275.
    連結:
  13. Keij SM, van Duijn-Bakker N, Stiggelbout AM, et al. What makes a patient ready for shared decision making? A qualitative study. Patient Educ Couns 2021;104:571-7.
    連結:
  14. Kessels RP. Patients' memory for medical information. J R Soc Med 2003;96:219-22.
    連結:
  15. Barello S, Triberti S, Graffigna G, et al. eHealth for Patient engagement: A systematic review. Front Psychol 2015;6:2013.
    連結:
  16. van de Wetering R. IT-enabled clinical decision support: An empirical study on antecedents and mechanisms. J Healthc Eng 2018;6945498.
    連結:
  17. Langford A, Orellana K, Kalinowski J, et al. Use of tablets and smartphones to support medical decision making in US adults: Cross-sectional study. JMIR Mhealth Uhealth 2020;8:e19531.
    連結:
  18. Marshall B, Cardon P, Poddar A, et al. Does sample size matter in qualitative reseach?: A review of qualitative interviews in is research. J Comput Inform Syst 2013;54:11-22.
    連結:
  19. Hawley ST, Li Y, An LC, et al. Improving breast cancer surgical treatment decision making: The iCanDecide randomized clinical trial. J Clin Oncol 2018;36:659-66.
    連結:
  20. Subramanian L, Zhao J, Zee J, et al. Use of a decision aid for patients considering peritoneal dialysis and in-center hemodialysis: A randomized controlled trial Am J Kidney Dis 2019;74:351-60.
    連結:
  21. Madrigal VN, Kelly KP. Supporting family decision-making for a child who is seriously ill: Creating synchrony and connection. Pediatrics 2018;142:S170-7.
    連結:
  22. Lawson ML, Shephard AL, Feenstra B, et al. Decision coaching using a patient decision aid for youth and parents considering insulin delivery methods for type 1 diabetes: a pre/post study. BMC Pediatr 2020;20:1.
    連結:
  23. Fischhoff B, Broomell SB. Judgment and decision making. Annu Rev Psychol 2020;71:331-55.
    連結:
  24. Mazo C, Kearns C, Mooney C, et al. Clinical decision support systems in breast cancer: A systematic review. Cancers (Basel) 2020;12:369.
    連結:
  25. Elwyn G, Frosch DL, Kobrin S. Implementing shared decision-making: consider all the consequences. Implement Sci 2016;11:114.
    連結:
  26. Niburski K, Guadagno E, Mohtashami S, et al. Shared decision making in surgery: A scoping review of the literature. Health Expect 2020;23:1241-9.
    連結:
  27. 衛生福利部國民健康署:106年癌症登記報告,衛生福利部,2020。https://www.hpa.gov.tw/Pages/Detail.aspx? nodeid=269&pid=12235./ Accessed June 2, 2020.
  28. 王英偉:醫病共享決策-決策輔助工具與臨床運用。醫療品質雜誌2016;10:15-24。
  29. Colaizzi P. Psychological research as the phenomenologist. New York: Oxford University Press; 1978.
  30. Wallner LP, Li Y, McLeod MC, et al. Decision-support networks of women newly diagnosed with breast cancer. Cancer 2017;123:3895-903.
  31. Irving LJ, Leon M. Decision making : A psychological analysis of conflict, choice, and commitment. Free Press, 1977.