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Participation and conflict in the decision-making process for endoscopic resection or surgical gastrectomy for early gastric cancer

 Hyuk Lee  ;  Yong Chan Lee  ;  Suji Shin  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Sung Hoon Noh 
 Journal of Surgical Oncology, Vol.106(1) : 101-106, 2012 
Journal Title
 Journal of Surgical Oncology 
Issue Date
Adult ; Aged ; Conflict (Psychology)* ; Decision Making* ; Female ; Gastrectomy/methods* ; Gastroscopy* ; Humans ; Male ; Middle Aged ; Negotiating* ; Patient Participation*/statistics & numerical data ; Personal Autonomy ; Physician-Patient Relations ; Prospective Studies ; Republic of Korea ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Surveys and Questionnaires ; Uncertainty
endoscopic resection ; gastrectomy ; gastric cancer ; decision making ; participation
BACKGROUND: This study was to evaluate the participation role and conflict of patients during the decision-making process for endoscopic or surgical treatment for early gastric cancer (EGC). METHODS: In this prospective observational study, the sequential survey for patients under consideration for treatment of differentiated EGC was performed at the tertiary referral center. RESULTS: Among the 82 responders, 63.4% preferred endoscopic resection. The total decisional conflict scores were high and significantly different between groups that preferred endoscopic resection or surgical treatment (44.8 vs. 51.6, P = 0.016). Values assigned to the two treatment attributes "preservation of stomach (OR = 0.51)" and "bother in case of incomplete resection (OR = 2.13)" clearly discriminated between patients reaching a final decision of surgical gastrectomy or endoscopic resection. Regarding the participation role, a shared role was more frequent in the group with preference for endoscopic treatment before consultation (42.3% vs. 24.0%, P = 0.045). However, at the time of therapeutic decision, the passive role was most remarkable, both for the endoscopic (53.2%) and surgical (71.4%) groups. CONCLUSION: Despite the high overall decisional conflict, patients with preference for endoscopic treatment tended to be more autonomous. After consultation, all patients exhibited a passive participation role in the decision-making process.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
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