Journal of Human Care Studies, Vol.3
October 2002, pp.48-53

An Investigation into the Choice of Treatment
by usig Diabetic Patients’ Scenario: Cognitions of Nurses
Hisako ADACHI *Abstract
Making a trade-off between Quality of Life (QOL) and Length (quantity) of Life (LL) in the medical treatment isinvolved in the process of deciding which treatment to choose for patients.
At present, there are many studies on cancer patients' treatment choice. However, there are not so many studies on
diabetic patients' treatment choice. Then, this paper aimed mainly to investigate the effect of the age and marital factors
on the treatment choice of diabetic patients.
233 nurses (103 single and 130 married) were selected as subjects, and the range of subject's age are from 20 to 40years. Subjects were asked the reason why they chose the hemodialysis, by using the scenario describing the healthcondition of diabetic patients. Responses were classified into 5 categories (physical, psychological, social, survival
and others).
Results were as follows: 1) There were significant differences between the ratio of nurses who chose and who did
not choose hemodialysis on two factors age and marital status(p<.01). But, the difference among three age groups was
not significant. 2) As the reason why married nurses chose hemodialysis, numbers of the response classified into social
category (having children and a husband) were significantly larger than those of other categories on the reasons of thetreatment choices.
It was suggested that the child and the husband were important factors when they made a decision on the treatment
choices, and the age factor was not a good predictor to choose the treatment. Whereas it would be necessary to investigate on diabetic elderly persons in order to explicate the mechanism of diabetic patients' treatment choice.

(diabetic patients)(treatment)

QOL

LL

(decision making)(nurse)(Key words)

ex.
1999

*2002

72

2002

Nursing Course, School of Medecine, Gifu University
8 26

Quality ofLife QOL

Quantity of Life,

Length of Life LL

trade-off
QOL

LL

QOL

LL

McNeil, B. J., Weichselbaum, R., & Pauker,
S.G. 1978, 1981

O’Connor, A. M., Boyd, N. F., &Stolbach, P. W. et al. 1987 O’Connor, A. M. 1989
Kiebert, G. M., Stiggelbout, A. M., & Kievit, J et al.
1994

Brundage, M. D., Davidson, J. R., & Mackillop,

W. J. et al. 1998
McNeil1981

QOL

Brundage
LL

1998

trade-off360%
Sackett, D.L. & Torrance G.W. 1978 Slevin M. L. L.,

O’Connor 1989

Stubbs H. J. & Plant P. et al.1990

50%
Kiebert

2

1994

1
QOL

QOL

6negative

QOL

32

LL

233
Table 1

532

Table 2110
77.7 % 181

222.3 % 52
CR= 8.45,p<.0120

CR= 3.35, p<.01 30

CR= 6.11, p<.01 40

CR= 5.17, p<.01201414030

32= 4.49, df= 1 , p<.05

20240
Table 3207.2%
1360703030p<.0540

CR= 2.20, p<.05 40

CR = 2.53,20

CR= 4.43, p<.01:
CR= 7.36, p<.01

2030402

CR= 2.33, p<.01: CR= 3.34,p<.01: CR= 6.36, p<.01=70.5, df= 5 ,p<.01

CR= 2 .14, p<.01:

CR= 4.86, p<.01: CR= 4.60, p<.01

CR= 4.53, p<.01

2

CR=10.45, p<.013040
CR= 3.85, p<.01 CR=2.93, p<.01

Table 4

CR= 6.68, p<.012405Table 5585401360702QOLLLQOL

LL

70.3%
Yellen, S.B., & Cella, D. F. 1995

2QOLLL

12020404050

6070

Brundage, M. D., Davidson, J. R., & Mackillop, W. J. etal. 1998 Using a treatment- tradeoff method to elicit preferences for the treatment of locally advanced non-smallcell lung cancer. Medical Decision Making, 18 (3), 256267.
Kiebert, G. M., Stiggelbout, A. M., & Kievit, J. et al. 1994
Choices in oncology: Factors that influence patients’treatment preference. Quality of Life Research, 3 , 175182.

McNeil, B. J., Weichselbaum, R., & Pauker, S. G. 1978
Fallacy of the five-year survival in lung cancer. New
England Journal of Medicine, 299, 1397-1401.
McNeil, B. J., Weichselbaum, R., & Pauker, S. G. 1981
Speech and survival: tradeoffs between quality and quantity of life in larygeal cancer. New England Journal ofMedicine, 305 (17), 982-987.
O’connor, A. M., Boyd, N. F., & Stolbach, P. W. et al. 1987
Eliciting preferences for alternative drug therapies in oncology: Influence of treatment outcome description technique and treatment experience on preferences. Journal ofChronic Disease, 40 (8), 811-818.
O’connor, A M. 1989 Effects of framing and level of probability on patients preferences for cancer chemotherapy.
Journal of Clinical Epidemiology, 42 (2), 119-126.
1999.
, 102 (7), 918-924.
Sackett, D.L., & Torrance, G.W. 1978 The utility of different health states as perceived by the general public. Journal of Chronic Disease, 31, 697-704.
Slevin, M. L. L., Stubbs, H. J., & Plant, P. et al. 1990 Attitude
to chemotherapy: Comparing views patients with cancer
with those of doctors, nurses, and general public. British
Medical Journal, 300, 1458-1460.
Yellen, S. B., & Cella, D. F. 1995 Someone to live for:Social well-being, parenthood status, and decision- making in oncology. Journal of Clinical Oncology, 13 (5),1255-1264.