Cultural challenges to engaging patients in shared decision making

Hawley, Sarah T.; Morris, Arden M.

doi:10.1016/j.pec.2016.07.008

Cited by 123 publications

(78 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, these studies have tended to overreach with regard to conclusions regarding the presence of disparities based on very small differences between SES subgroups in a limited number of clinical settings. Nevertheless overall, the results of the current study identifying areas for improving the engagement of Latina patients in treatment decision making and patient‐clinician communication are consistent with prior work that calls for more culturally tailored and patient‐centered communication around cancer treatment …”

Section: Discussionsupporting

confidence: 86%

“…For these types of patients, cancer clinicians have a special responsibility to provide support in their navigation of decision making and deliberation regarding treatment choices. Strategies to increase engagement and address these issues in this patient population could include communication skills and cultural competence training for clinicians . The fact that many patients receive news of their diagnosis from nononcology providers underscores the need for this training even among providers not directly connected to cancer care.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment experiences of Latinas after diagnosis of breast cancer

Wallner

Abrahamse

Janz

et al. 2017

Cancer

Self Cite

View full text Add to dashboard Cite

Objectives We examined race/ethnic differences in patient perspectives about their breast cancer treatment experiences. Methods A weighted random sample of women newly diagnosed with breast cancer in 2013–15 in Los Angeles County and Georgia were sent surveys 2 months after surgery (N=5,080, 70% response rate). The analytic sample was limited to patients in Los Angeles County (N=2,397). Results The pattern of visits with different specialists before surgery was similar across race/ethnic groups. Low acculturated Latinas (Latinas-LA) were less likely to report high clinician communication quality for both surgeons and medical oncologists (under 69% vs over 72% for all other groups, p<.05). The proportion of patients who reported high satisfaction about how doctors worked together was similar across race/ethnic groups. Latinas-LA were more likely to have a low autonomy decision style (48% vs 24%–50% for all other groups, p<.001) and were more likely to report getting too much information vs other ethnic groups (20% vs <16% for other groups, p<.001). Patients who reported a low autonomy decision style were more likely to rate amount of information received for the surgery decision as “too much” (16% vs 9%, p<.001). Conclusions There is moderate disparity in breast cancer treatment communication and decision making experiences reported by Latinas with low acculturation vs other groups. The approach to treatment decision making by Latinas with low acculturation represents an important challenge to health care providers. Initiatives are needed to improve patient engagement in decision-making and increase clinician awareness of these challenges in this patient population.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Treatment experiences of Latinas after diagnosis of breast cancer

Wallner

Abrahamse

Janz

et al. 2017

Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…Additionally, beyond language itself, cultural behaviors may lead older adults deliberately to defer to their younger family members and/or to the clinician; particularly when it comes to racial and ethnic minorities . This is an example of where a dogmatic approach to shared decision‐making is inappropriate.…”

Section: Challenges Of Shared Decision‐making With Older Adultsmentioning

confidence: 99%

Shared decision‐making for older adults with cardiovascular disease

Backman

Levine

Wenger

et al. 2019

Clinical Cardiology

View full text Add to dashboard Cite

Shared decision‐making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient preferences, and a mutual agreement on the best course of action to meet the patient's personal goals. For older adults, there are common challenges and considerations with regard to shared decision‐making, some of which (eg, cognitive impairment) may be biologically linked to cardiovascular disease. There are tools designed to facilitate the shared decision‐making process, known as decision aids, which are broadly effective although have shortcomings when applied to older adults. Novel approaches in clinical research and health systems changes will go some way toward improving shared decision‐making for older adults, but the greatest scope for improvement may be within the grass roots areas of communication skills, interdisciplinary teamwork, and simply asking our patients what matters most.

show abstract

“…Valuing patients’ personal time is crucial to positive customer service relations. Regardless of the strategies selected for action, the growing Hispanic population requires additional efforts to promote shared decision making and improve health outcomes (Hawley & Morris, 2017). …”

Section: Practice Implicationsmentioning

confidence: 99%

“…For patients from culturally diverse backgrounds, culturally competent healthcare is an essential aspect of person-centered care (Hawley & Morris, 2017; OMH & USDHHS, n.d.). Lower feelings of discrimination have been reported by Hispanics when they have perceived healthcare providers to be respectful and sensitive to their culture (Becerra, Androff, Messing, Castillo, & Cimino, 2015; Nápoles et al, 2012).…”

mentioning

confidence: 99%

US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

Amirehsani

Wallace

et al. 2017

Journal of Community Health Nursing

View full text Add to dashboard Cite

Hispanics in the U.S. experience significant health disparities. Using focus groups conducted in Spanish, we explored the perspectives of 172 Hispanic adults regarding their healthcare experiences. Many participants were female (64.5%) and primarily from Mexico (80%). Four major qualitative themes emerged: 1) provide us with information, 2) want attentive and respectful relationships, 3) want better care, and 4) perceived discrimination. Suboptimal patient-provider interactions were described. Research is needed to explore interventions that address these issues. Incorporating person-centered care principles and practices such as clear and understandable communication, culturally competent care, and customer service skills may benefit provider interactions with Hispanics.

show abstract

Cultural challenges to engaging patients in shared decision making

Cited by 123 publications

References 55 publications

Treatment experiences of Latinas after diagnosis of breast cancer

Treatment experiences of Latinas after diagnosis of breast cancer

Shared decision‐making for older adults with cardiovascular disease

US Healthcare Experiences of Hispanic Patients with Diabetes and Family Members: A Qualitative Analysis

Contact Info

Product

Resources

About