Decisional Control Preferences, Disclosure of Information Preferences, and Satisfaction Among Hispanic Patients With Advanced Cancer

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• 作者：Antonio Noguera ; MD^a ; ^c ; Sriram Yennurajalingam ; MD ; MS^a ; Isabel Torres-Vigil ; DrPH^a ; ^d ; Henrique Afonseca Parsons ; MD ; MS^a ; Eva Rosina Duarte ; MD^e ; Alejandra Palma ; MD^f ; Sofia Bunge ; MD^g ; J. Lynn Palmer ; PhD^b ; Eduardo Bruera ; MD^a ; ^{ebruera@mdanderson.org" class="auth_mail}
• 关键词：Palliative care ; decisional control preferences ; disclosure of information preferences ; advanced cancer
• 刊名：Journal of Pain and Symptom Management
• 出版年：May 2014
• 年：2014
• 卷：47
• 期：5
• 页码：896-905
• 全文大小：146 K

文摘

Studies to determine the decisional control preferences (DCPs) in Hispanic patients receiving palliative care are limited.

Objectives

The aims of this study were to describe DCPs, disclosure of information, and satisfaction with decision making among Hispanics and to determine the degree of concordance between patients' DCPs and their self-reported decisions.

Methods

We surveyed 387 cancer patients referred to outpatient palliative care clinics in Argentina, Chile, Guatemala, and the U.S. DCPs were measured with the Control Preference Scale, disclosure preferences with the Disclosure of Information Preferences questionnaire, and satisfaction with care with the Satisfaction with Decision Scale.

Results

In this study, 182 patients (47.6%) preferred shared decisional control, 119 (31.2%) preferred active decisional control, and 81 (21.2%) preferred a passive approach. Concerning their diagnosis and prognosis, 345 (92%) patients wanted to know their diagnosis, and 355 (94%) wanted to know their prognosis. Three hundred thirty-seven (87%) patients were satisfied with the decision-making process. DCPs were concordant with the self-reported decision-making process in 264 (69%) patients (weighted kappa = 0.55). Patients' greater satisfaction with the decision-making process was correlated with older age (P ≤ 0.001) and with a preference for enhanced diagnostic disclosure (P ≤ 0.024). Satisfaction did not correlate with concordance in the decision-making process.

Conclusion

The vast majority preferred a shared or active decision-making process and wanted information about their diagnosis and prognosis. Older patients and those who wanted to know their diagnosis seemed to be more satisfied with the way treatment decisions were made.