癌症病人的治療決策過程

Treatment Decision-Making Process of Cancer Patients

隨著醫療科技進步與國內癌症發生率的增長，癌症病人的治療選擇益趨多元與複雜，是個困難的決定。協助癌症病人進行知情且符合個人價值取向的治療選擇，是護理人員重要的職責。病人的治療決策行為，是依其對癌症與治療的知識素養，進行價值澄清與期望權衡的資料處理認知過程。面對癌症與治療的生命與生活品質威脅性，病人的癌症治療選擇有其不確定與風險性，常是在情緒衝擊下的兩難抉擇。本文以基礎決策理論與文獻彙整，說明癌症病人的治療決策行為，論述決策過程中的知識需求、決策困擾、決策參與，與共同治療決策與決策支持的發展趨勢，以供後續臨床照護措施與研究發展之參考。

The decision-making process that is used by cancer patients to determine their treatment has become more multi-foci, difficult and complicated in recent years. This has in part been attributed to the increasing incidence rate of cancer in Taiwan and the rapid development of medical technologies and treatment modalities. Oncology nurses must assist patients and family to make informed and value-based treatment decisions. Decision-making is an information process that involves appraising one’s own expectation and values based on his/her knowledge on cancer and treatment options. Because cancer treatment involves risks and uncertainties, and impacts quality of life, the treatment decision- making for cancer is often stressful, or even conflicting. This paper discusses the decision-making behaviors of cancer patients and the decisional conflict, participation, and informational needs that are involved in cancer treatment. The trend toward shared decision-making and decisional support will be also explored in order to facilitate the future development of appropriate clinical interventions and research.