“I need to know what makes somebody tick …”: Challenges and Strategies of Implementing Shared Decision-Making in Individualized Oncology

Haltaufderheide, Joschka; Wäscher, Sebastian; Bertlich, Bernhard; Vollmann, Jochen; Reinacher‐Schick, Anke; Schildmann, Jan

doi:10.1634/theoncologist.2017-0615

Cited by 19 publications

(22 citation statements)

References 32 publications

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“…“Values” were variously described as what matters most to a patient, 13 a patient's assignment of interest depending on their moral beliefs, 14 what a patient considers most important to their well‐being and health, 12 and what a patient considers important in daily life 15,16 . One paper used patients' selected “most important attribute” (a characteristic of a treatment option) as a proxy for their values 17 .…”

Section: Resultsmentioning

confidence: 99%

“…Second, individuals were observed to lack clarity about weighing available options or courses of action. Values elicitation was described as particularly beneficial when individuals lacked clarity about their feelings or the consequences or trade‐offs of different options 18 or if there was uncertainty about the “medically best option.” 14 For example, one study 12 noted that the treatments of patients with multiple chronic conditions can conflict (e.g., drug–drug interactions), which can lead to several different courses of action. Given this clinical uncertainty, which can be impactful for both patients and healthcare professionals, improvement of care requires the consideration of patient values in the context of specific diagnostic or therapeutic decisions 12 …”

Section: Resultsmentioning

confidence: 99%

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Values elicitation among adults making health‐related decisions: A concept analysis

et al. 2022

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Aim To conduct a concept analysis of values elicitation in the context of health care and treatment decision‐making and formulate a conceptual definition. Background Values elicitation is a commonly cited term for an activity to help patients identify values and evaluate their application in health care decision‐making, yet it remains ambiguous and difficult to differentiate from similar concepts. Design Concept analysis. Data Source Three databases, including PubMed, CINAHL Plus, and Scopus, were searched from inception to February 2021. Review Methods Walker and Avant's eight‐stage method was used to identify attributes, cases, antecedents, consequences, and empirical referents and formulate a conceptual definition. Results The concept analysis identified 3 attributes, 10 consequences, 7 antecedents, and 3 empirical referents. Our analysis defines values elicitation as an intentional process whereby individuals explore their core beliefs, alone or with others, to (1) determine their preference, or a lack thereof, between health or treatment options, and (2) frame decisions. Conclusions The findings have the potential to influence the identification, discussion, and measurement of values elicitation by nurses and researchers across disciplines. Further exploration of this concept is warranted as the literature continues to emerge.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Values elicitation among adults making health‐related decisions: A concept analysis

et al. 2022

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“…In addition, the study also found women who engaged in a contract or part-time work had a lower probability of experiencing decision regret than women with working full-time [11]. Because of the heavy medical burden in China, BC patients built a poor communication with clinicians and had no time to discuss the type of cancer, treatment, and a person's preferences and perceptions of treatment choices [30][31][32][33]. \With the spread of shared decision making, the physicians encourage patients to positively participate in treatment decision aiming to meet patients' needs and preference [27].…”

Section: Discussionmentioning

confidence: 95%

Relationship Between Decision Conflict and Decision Regret Among Postoperative Breast Cancer Patients in China: the Regulating Role of Decision-making Preparation

Wang

Zhang

Pang

et al. 2021

Preprint

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Objective: Different surgical methods have different risks and benefits.Chinese breast cancer(BC) patients’ decision-making of surgical treatment becomes a critical research question. Patients are often offered several options before surgery, and decision preparation plays an important role in the decision process. However some patients regret the original decision afterward. To understand the current situation, this study explore mainly explores the status of decision regret among postoperative breast cancer patients,and tests the relationship between decision conflicts, decision-making preparation, and decision regret. Methods: A cross-sectional survey was carried out. Totally 320 postoperative BC patients were studied using a self-made general data scale, Decision Regret Scale, Decision Conflict Scale, and Preparation for Decision Making Scale. Basic descriptive analyses, Pearson’s correlation analyses and regression analyses were performed. Results: The average score of decision regret among BC patients after surgery was 34.28. Decision regret was positively associated with decision conflict (r=0.853, p<0.01), and negatively associated decision preparation (r=-0.404, p<0.01). Decision-making preparation plays a regulatory role for the emergence of decision conflicts and regrets. The correlation between decision conflicts and decision regret increases with the increase in decision-making preparation. Conclusion: The adverse effects of decision conflicts on decision regret gradually increase with the increase in decision-making preparation. Results indicate that reducing decision preparation can be expected to improve the level of decision regret among Chinese postoperative BC patients.Thus, Clinical staffs should encourage patients to take an active part in decision-making, provide specialized information support, and improve the level of decision regret among Chinese BC patients after surgery.

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“…SDM is one of the essential dimensions in a patient-centered care approach and an ethical framework for decision-making in cancer care [ 26 ]. SDM is based on the available evidence, along with the patient’s values, wishes, and preferences [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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“I need to know what makes somebody tick …”: Challenges and Strategies of Implementing Shared Decision-Making in Individualized Oncology

Cited by 19 publications

References 32 publications

Values elicitation among adults making health‐related decisions: A concept analysis

Values elicitation among adults making health‐related decisions: A concept analysis

Relationship Between Decision Conflict and Decision Regret Among Postoperative Breast Cancer Patients in China: the Regulating Role of Decision-making Preparation

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

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