| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 99 === Abstract
Purposes: This study explored medical decisional conflict of treatment in patients with brain tumor and factors associated with the match between actual and preferred role of involvement in this decision.
Methods: This is a cross-sectional descriptive study. A purposive sampling of neurosurgery patients with age 18 years at least and newly diagnosed brain tumor from one medical center in northern Taiwan was recruited. Data were collected from May 1st 2010 to June 25th 2010 with Control Preference Scale and Decision Conflict Scale. A total of 61 participants were distributed.
Results: The majority (40.9%) preferred active role in decision making, the next is passive role (39.4%), and the minority is collaborative role (19.7%). Most of women, younger or unmarried clients desired to decide on their own; however, ones with educational level in college, malignant tumor or without experience of illness wanted to delegate the decision to their doctors. Participants in this study had decisional conflict. The conflict was composed of three dimensions, including state of uncertainty, lack of information, and insufficient support. The level of decisional conflict significantly correlated with age statistically (p=0.018). The older ones had the higher level of decisional conflict. 92.3% of all participants invited their families to involve this decision even if they made the final decision by themselves. Participants with more involvement of families had higher decisional conflict (p=0.007). 60.7% of patients met their preferred role of involvement and had lower level of decisional conflict than those with expectation gap in the role of involvement. Participants who perceived more control than preferred had more decisional conflict. Conclusions: In critically clinical professional situation, making medical decisions for patients result in complex and difficult conflict. Patients are not professionals in medical, thus they expect to be involved more in decision-making and make a decision with someone’s help. Physicians should give consideration to wills of patients and the participation of families. Nurses could be coordinators between physicians, patients and families to make communication lines open and meet expectations. The objective is to eliminate barriers between patients and medical teams and to diminish the level of the conflict for patients in medical decision-making.
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