Health locus of control in cancer patient and oncologist decision-making: An exploratory qualitative study

Abstract

Objective To investigate how cancer patients’ and family members’ perspective and health locus of control are presented in clinical encounter decision-making. Methods Semi-structured in-depth interviews were carried out with 16 cancer patients and 6 family members living in Israel (n = 22). Interviews were transcribed verbatim, and data were analyzed using thematic analysis. Results Following the health locus of control model, the findings were divided into an external and internal locus of control themes, and we added a theme regarding shared decision-making. Internal locus of control sub-themes included asking for a second opinion, negotiating with the doctor, asking questions, looking for information, and fighting for their rights. External locus of control sub-themes included powerful others, oncologists, and fate. The dominant approach of most of the interviewees was an external locus of control. Women demonstrated more external locus of control than men. On the direct question of who should decide on treatment—the doctor, the patient, or both jointly—the answers ranged from only the doctor (n = 8) to together (n = 7) to only the patient (n = 8). Conclusions This study provides insights into different aspects of locus of control in the clinical encounter involving cancer patients. The findings reflect the need to devote comprehensive attention to cancer patients’ perceptions and experiences in the clinical encounter. A patient-centered care approach and a personalized framework for decision-making in cancer care are essential to achieving better treatment outcomes. Further research can engage in the development and validation of an up-to-date health locus of control questionnaire for cancer patients based on the findings of this study.

Decisional conflict, caregiver mastery, and depression among Chinese parental caregivers of children with leukemia

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“…While most studies link belief in god or fatalism to positive physical outcomes (Sprik et al, 2021; Vardar et al, 2021), functional well-being (Leyva et al, 2014), sensemaking (Keeley et al, 2009), and positive coping (Vardar et al, 2021), few have investigated the role of belief in god and/or fate in cancer-related decision-making. For instance, Dopelt et al (2022) using qualitative interviews explored cancer patients’ and family caregivers’ health locus of control with respect to clinical decision-making. They found that some patients relied on the belief in fate, leading them to adopt a passive stance in decision-making and refrain from asking questions.…”

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