Does the use of shared decision-making consultation behaviors increase treatment decision-making satisfaction among Chinese women facing decision for breast cancer surgery?

2014 ◽  
Vol 94 (2) ◽  
pp. 243-249 ◽  
Author(s):  
Wendy W.T. Lam ◽  
Marie Kwok ◽  
Miranda Chan ◽  
Wai Ka Hung ◽  
Marcus Ying ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Chinese Women ◽  
Treatment Decision ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Shared Decision ◽  
Treatment Decision Making

“It’s important to me”: A qualitative analysis of shared decision-making and patient preferences in early-stage breast cancer patients.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 227-227
Author(s):  
Valerie Lawhon ◽  
Rebecca England ◽  
Audrey S. Wallace ◽  
Courtney Williams ◽  
Stacey A. Ingram ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Patient Preferences ◽  
Early Stage ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Early Stage Breast Cancer ◽  
Shared Decision ◽  
Treatment Decision Making

227 Background: Shared decision-making (SDM) occurs when both patient and provider are involved in the treatment decision-making process. SDM allows patients to understand the pros and cons of different treatments while also helping them select the one that aligns with their care goals when multiple options are available. This qualitative study sought to understand different factors that influence early-stage breast cancer (EBC) patients’ approach in selecting treatment. Methods: This cross-sectional study included women with stage I-III EBC receiving treatment at the University of Alabama at Birmingham from 2017-2018. To understand SDM preferences, patients completed the Control Preferences Scale and a short demographic questionnaire. To understand patient’s values when choosing treatment, semi-structured interviews were conducted to capture patient preferences for making treatment decisions, including surgery, radiation, or systemic treatments. Interviews were audio-recorded, transcribed, and analyzed using NVivo. Two coders analyzed transcripts using a constant comparative method to identify major themes related to decision-making preferences. Results: Amongst the 33 women, the majority of patients (52%) desired shared responsibility in treatment decisions. 52% of patients were age 75+ and 48% of patients were age 65-74, with an average age of 74 (4.2 SD). 21% of patients were African American and 79% were Caucasian. Interviews revealed 19 recurrent treatment decision-making themes, including effectiveness, disease prognosis, physician and others’ opinions, side effects, logistics, personal responsibilites, ability to accomplish daily activities or larger goals, and spirituality. EBC patient preferences varied widely in regards to treatment decision-making. Conclusions: The variety of themes identified in the analysis indicate that there is a large amount of variability to what preferences are most crucial to patients. Providers should consider individual patient needs and desires rather than using a “one size fits all” approach when making treatment decisions. Findings from this study could aid in future SDM implementations.

scholarly journals Effect of a Decision Aid on Knowledge and Treatment Decision Making for Breast Cancer Surgery

JAMA ◽  
2004 ◽  
Vol 292 (4) ◽  
pp. 435 ◽  
Author(s):  
Timothy Whelan ◽  
Mark Levine ◽  
Andrew Willan ◽  
Amiram Gafni ◽  
Ken Sanders ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Decision Aid ◽  
Treatment Decision ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Treatment Decision Making

scholarly journals An absence of equipoise: Examining surgeons’ decision talk during encounters with women considering breast cancer surgery

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260704
Author(s):  
Mary C. Politi ◽  
Catherine H. Saunders ◽  
Victoria F. Grabinski ◽  
Renata W. Yen ◽  
Amy E. Cyr ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Usual Care ◽  
Shared Decision Making ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Breast Conserving Surgery ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Shared Decision

Shared decision-making is recommended for decisions with multiple reasonable options, yet clinicians often subtly or explicitly guide choices. Using purposive sampling, we performed a secondary analysis of 142 audio-recorded encounters between 13 surgeons and women eligible for breast-conserving surgery with radiation or mastectomy. We trained 9 surgeons in shared decision-making and provided them one of two conversation aids; 4 surgeons practiced as usual. Based on a published taxonomy of treatment recommendations (pronouncements, suggestions, proposals, offers, assertions), we examined how surgeons framed choices with patients. Many surgeons made assertions providing information and advice (usual care 71% vs. intervention 66%; p = 0.54). Some made strong pronouncements (usual care 51% vs. intervention 36%; p = .09). Few made proposals and offers, leaving the door open for deliberation (proposals usual care 21% vs. intervention 26%; p = 0.51; offers usual care 40% vs. intervention 40%; p = 0.98). Surgeons were significantly more likely to describe options as comparable when using a conversation aid, mentioning this in all intervention group encounters (usual care 64% vs. intervention 100%; p<0.001). Conversation aids can facilitate offers of comparable options, but other conversational actions can inhibit aspects of shared decision-making.

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