乳癌病人使用智慧型手機，應用程式輔助手術決策

Smartphone-Application Assisted Surgery Decision among Breast Cancer Patients

早期乳癌病患面對手術決策過程，常遇到決策困難，資訊應用在醫療決策上，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決策，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。

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.