Background: Shared Decision-Making (SDM) is important for patient-centred care, especially in areas such as gynaecological oncology where treatment decisions are often multifaceted. This study aimed to implement and measure SDM in a gynaecological oncology outpatient clinic, specifically assessing the impact of the BRAN (Benefits, Risks, Alternatives, Nothing) tool on patient and physician perceptions.Methods: A two-phased prospective observational and survey mixed-methodology study was conducted at the tertiary Northern Gynaecological Oncology Centre (NGOC) outpatient clinic in Gateshead, United Kingdom, from October 2023 to November 2024. SDM champions provided staff training. Patient and physician perspectives were measured using the nine-item Shared Decision Making Questionnaire (SDM-Q-9). Phase one was a baseline assessment; phase two involved the implementation of BRAN posters and leaflets. Statistical analyses included the Mann–Whitney U Test and Fisher’s Exact Test. A post-implementation online staff survey was conducted.Results: A total of 207 patients and 13 physicians participated: 107 patients and 13 physicians in phase one and 100 patients and 12 physicians in phase two. Whilst no statistically significant difference in patients’ perceptions of SDM was found between phases (p= 0.73), physicians’ perceptions showed a statistically significant improvement after BRAN tool implementation (p< 0.01). The staff survey results indicated that 84% observed increased patient involvement, and 92% agreed that SDM helped achieve consultation goals.Conclusions: The implementation of SDM at the NGOC led to a statistically significant improvement in the subjective use of SDM by physicians’, despite no significant change in patients’ perceptions, possibly due to high baseline levels. Staff reported increased patient engagement and improved consultation styles. These findings support implementing SDM in gynaecological oncology outpatient settings
背景：共享决策（SDM）对于以患者为中心的医疗至关重要，尤其在妇科肿瘤等治疗决策常涉及多方面的领域。本研究旨在妇科肿瘤门诊实施并评估SDM，特别关注BRAN（获益、风险、替代方案、不干预）工具对医患双方认知的影响。 方法：2023年10月至2024年11月期间，在英国盖茨黑德三级妇科肿瘤中心（NGOC）门诊开展了两阶段前瞻性观察与问卷调查混合研究。SDM推广专员对医护人员进行了培训。采用九项共享决策问卷（SDM-Q-9）评估医患双方认知。第一阶段为基线评估；第二阶段实施BRAN宣传海报与宣传册。统计分析采用曼-惠特尼U检验与费希尔精确检验，并于实施后开展了医护人员线上问卷调查。 结果：共207名患者与13名医师参与研究：第一阶段包括107名患者与13名医师，第二阶段包括100名患者与12名医师。虽然两阶段患者对SDM的认知无统计学显著差异（p=0.73），但医师认知在BRAN工具实施后呈现统计学显著改善（p<0.01）。医护人员问卷调查显示：84%的受访者观察到患者参与度提升，92%认同SDM有助于达成诊疗目标。 结论：NGOC实施SDM后，医师对SDM的主观运用呈现统计学显著改善，而患者认知未发生显著变化可能与基线水平较高有关。医护人员反馈患者参与度提升且诊疗模式得到优化。这些发现支持在妇科肿瘤门诊环境中推行SDM实践。
肿瘤(癌症)患者之家