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目的；本調査の目的は，日本の乳がん女性の医学的治療決定に関わる情報探索経験と意思決定役割を調査し，それらの関連を明らかにすることである．また，最初の意向よりも実際において，より能動的な役割を果たしたと感じた影響因子を探索することである．方法；乳がん女性を対象に，意思決定コントロール尺度と情報探索経験尺度を用い，回顧的に回答する横断的調査を実施した．意思決定役割と情報探索経験における各変数を比較する...際にχ２乗検定を実施した．意向よりも実際役割において，より能動的な役割を果たしたと感じた影響因子を調べるためにロジスティック回帰分析を実施した．結果；104 名の乳がん女性から回答を得た．78％の患者が乳がんに関する知識があると感じていて，ほとんどの患者が情報探索を行っていた．治療前に患者が抱いていた意向役割は，18％が積極的，69％が協働的，13％が消極的役割だった．彼女達が実際に経験したと感じた実際役割は，27％が積極的，43％が協働的，30％が消極的だった．意向役割と実際役割が一致した乳がん女性は59％だったが，ほとんどの患者は意思決定に満足を示した．乳がん女性の多くが，情報希求（49％），必要な情報取得への努力（53％），必要な情報取得時間不足（55％），情報探索時の不満（44％），情報の質に関する不安（45％），情報理解の困難（49％）を含む否定的な経験をしていた．この調査では，医師に感情を表出したり，乳房切除術を受けていたり，さらなる情報を求めた乳がん女性の方が最初の意向よりも実際において，より能動的役割を果たしたと感じていたことが明らかになった．要約；ほとんどの乳がん女性は情報探索を行い，治療を決定する際に医師と協働的役割をとりたいと感じている．主治医に感情を表出したり，乳房切除術を受けたり，情報を希求した患者は実際の意思決定役割をより能動的な選択へと変化させた可能性が高いと考えられる．
Purpose : To investigate the information-seeking experiences and decision-making roles of Japanese women with breast cancer, to examine the relationship between information-seeking experiences and decision-making roles, and to explore the factors that influenced taking a more active role than the preferred role during the treatment decision-making process. Methods : In a cross-sectional study, women with breast cancer were retrospectively administered the Control Preferences Scale and the Information-Seeking Experience Scale. The Chi-Square test was used to compare differences among individual variables in decision-making roles and information-seeking experiences. Logistic regression analysis was used to explore the factors that influenced taking a more active role than the preferred role. Results : One hundred and four patients with breast cancer participated in the investigation. Eighty-five patients (78%) perceived themselves as having knowledge of breast cancer and most patients (92%) sought information on breast cancer. The preferred roles in decision-making that they reported having before treatment were 18% active, 69% collaborative and 13% passive. The actual roles they perceived having experienced were 27% active, 43% collaborative and 30% passive. Although there was concordance of preferred and actual role for only 59% of the women, most patients reported that they were satisfied with their decision-making. Many women with breast cancer reported negative experiences with information seeking, including wanting more information (49%), expending a lot of effort to obtain the information needed (53%), not having enough time to obtain needed information (55%), frustration during the search for information (44%), concerns about the quality of the information (45%) and difficulty understanding the information received (49%). This study revealed that having a more active actual role than the initial preferred role was associated with emotional expression to the physician, having undergone mastectomy, and the desire for more information. Conclusion : Most women with breast cancer sought information on breast cancer and expressed a preference for a collaborative relationship with physicians in treatment decision-making. Patients who expressed emotion to their physician, wanted more information, and underwent mastectomy were most likely to change their actual decision-making role toward a more active choice.続きを見る
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