Interventions for promoting participation in shared decision-making for children with cancer

Coyne, Imelda; O’Mathúna, Dónal P; Gibson, Faith; Shields, Linda; Sheaf, Greg

doi:10.1002/14651858.cd008970.pub2

Cited by 63 publications

(32 citation statements)

References 57 publications

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“…44,45 However, with few exceptions, 44, 46, 47 the reviewed papers did not typically assess for differences based on demographic features, or include these factors in statistical analysis to control for confounding. In general, SDM research demonstrates a lack of focus on particular important demographic categories (e.g., pediatrics 48 ).…”

Section: Discussionmentioning

confidence: 99%

Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

171

151

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Objective Shared Decision-Making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known however regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources Pubmed, CochraneCENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases Review Methods We searched for English-language studies (1/1/1990 to 8/9/2015) evaluating use of SDM in elective surgical care. Identified studies were independently screened by two reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7/24) followed by joint (5/24) and gynecological surgery (4/24). Twenty studies used decision aids/support tools, including modalities that were multimedia/video (13/20), written (3/20), or personal coaching (4/20). Effect of SDM on preference for surgery were mixed across studies, showing a decrease in surgery (9/24), no difference (8/24), or increase (1/24). SDM tended to improve decision quality (3/3) as well as knowledge/preparation (4/6), while decreasing decision conflict (4/6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.

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Section: Discussionmentioning

confidence: 99%

Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

171

151

View full text Add to dashboard Cite

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“…Coyne et al 43 set out to identify randomised controlled trial (RCT) studies examining the effects of shared decision-making interventions on the process of shared decision-making for 4 to 18-year olds with cancer. They were unable to identify any such studies, concluding among other things, that much ‘evidence promoting young people’s participation in decision-making is authored by policy makers and that we lack strong evidence from research that supports these recommendations’.…”

Section: Discussionmentioning

confidence: 99%

Current understanding of decision-making in adolescents with cancer: A narrative systematic review

et al. 2016

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Background:Policy guidance and bioethical literature urge the involvement of adolescents in decisions about their healthcare. It is uncertain how roles and expectations of adolescents, parents and healthcare professionals influence decision-making and to what extent this is considered in guidance.Aims:To identify recent empirical research on decision-making regarding care and treatment in adolescent cancer: (1) to synthesise evidence to define the role of adolescents, parents and healthcare professionals in the decision-making process and (2) to identify gaps in research.Design:A narrative systematic review of qualitative, quantitative and mixed-methods research. We adopted a textual approach to synthesis, using a theoretical framework of interactionism to interpret findings.Data Sources:The databases MEDLINE, PsycINFO, SCOPUS, EMBASE and CINHAL were searched from 2001 through May 2015 for publications on decision-making for adolescents (13–19 years) with cancer.Results:Twenty-eight articles were identified. Adolescents and parents initially find it difficult to participate in decision-making due to a lack of options in the face of protocol-driven care. Parent and adolescent preferences for information and response to loss of control vary between individuals and over time. No studies indicate parental or adolescent preference for a high degree of independence in decision-making.Conclusion:Striving to make parents and adolescents fully informed or urge them towards more independence than they prefer may add to distress and confusion. This may interfere with their ability to participate in their preferred way in decisions about care and treatment. Future research should include analysis of on-ground interactions among parents, adolescents and clinicians across the trajectory.

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“…Factors influencing decisional preferences need to be specified from adolescent perspectives so that the guiding principles reflect their insight and can thus become the basis of a best practice guideline. Because of the current lack of clinical interventions to promote shared decision making for adolescents with cancer, 1 the study team formatted the semantic content analyses' confirmed interview findings into a proposed decisional aid model.…”

Section: Statement Of Purposementioning

confidence: 99%

“…[1][2][3] Prior investigations of adolescent oncology patients have revealed that this population can capably engage in complex decisional processes from the time of diagnosis and treatment 4 through decisions such as fertility preservation, 5 research participation, 6 advanced care planning, 7 and end-of-life decisions. 8 Parents and providers report satisfaction when adolescent oncology patients are able to convey preferences and participate in decision-making discussions.…”

Section: Introductionmentioning

confidence: 99%

Adolescents' preferences for treatment decisional involvement during their cancer

Weaver

Baker

Gattuso

et al. 2015

Cancer

152

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BACKGROUND: This qualitative study investigated the medical decision-making preferences of adolescent oncology patients and the parental and clinician behaviors that adolescents report to be supportive of their preferred level of decision-making involvement. METHODS: Interviews were conducted with 40 adolescents between the ages of 12 and 18 years who were undergoing cancer treatment in Memphis, Tenn or Washington, DC. Role preferences were converted into a predetermined Likert scale decisional preference score. A semantic content analysis was used to analyze patient reports of parental behaviors, attitudes, knowledge levels, and relational interactions that facilitated their preferred level of involvement in decision making. Clinician behaviors described as supportive of decisional processes were also categorized thematically. A teen advisory council validated study findings. Data reporting followed strict adherence to Consolidated Criteria for Reporting Qualitative Research guidelines. RESULTS: Adolescents indicated a spectrum of preferred decisional roles, with the most common being an actively involved role (26 of 40 or 65%), although a shared decisionmaking approach was still valued. There was no statistically significant difference in the preferred decisional role with respect to demographic or medical characteristics, including the relapse status, although adolescents who preferred autonomous interview settings were more likely to prefer active decisional roles (P <.001). Adolescents recognized that situational and social contexts might shift their preferred level of involvement in medical decisions. Although adolescents wanted to be involved in decisions, they also expressed an appreciation of family insight, parental presence, and clinician guidance. CONCLUSIONS: Adolescents with cancer are able to retrospectively identify their preferences for inclusion in medical decision making, and even when preferring involvement, they value the input of trusted others. Cancer 2015;121:4416-24.

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Interventions for promoting participation in shared decision-making for children with cancer

Cited by 63 publications

References 57 publications

Shared Decision Making and Choice for Elective Surgical Care

Shared Decision Making and Choice for Elective Surgical Care

Current understanding of decision-making in adolescents with cancer: A narrative systematic review

Adolescents' preferences for treatment decisional involvement during their cancer

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