Participation in decision making regarding type of surgery and treatment-related satisfaction in North Indian women with early breast cancer

Agrawal, Sushma; Goel, Anshu; Lal, Punita

doi:10.4103/0973-1482.98974

Cited by 13 publications

(59 citation statements)

References 13 publications

(16 reference statements)

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“…All 32 included publications had a cross‐sectional study design, 11 of which derived their patient population from previous cohort studies, or from the control group of a randomized trial. Twenty of the 32 studies were published after 2010, 11 between 2000 and 2010, and one in 1989.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of shared decision-making in surgery

Mik

Stubenrouch

Balm

et al. 2018

British Journal of Surgery

126

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BackgroundMultiple treatment options are generally available for most diseases. Shared decision‐making (SDM) helps patients and physicians choose the treatment option that best fits a patient's preferences. This review aimed to assess the extent to which SDM is applied during surgical consultations, and the metrics used to measure SDM and SDM‐related outcomes.MethodsThis was a systematic review of observational studies and clinical trials that measured SDM during consultations in which surgery was a treatment option. Embase, MEDLINE and CENTRAL were searched. Study selection, quality assessment and data extraction were conducted by two investigators independently.ResultsThirty‐two articles were included. SDM was measured using nine different metrics. Thirty‐six per cent of 13 176 patients and surgeons perceived their consultation as SDM, as opposed to patient‐ or surgeon‐driven. Surgeons more often perceived the decision‐making process as SDM than patients (43·6 versus 29·3 per cent respectively). SDM levels scored objectively using the OPTION and Decision Analysis System for Oncology instruments ranged from 7 to 39 per cent. Subjective SDM levels as perceived by surgeons and patients ranged from 54 to 93 per cent. Patients experienced a higher level of SDM during consultations than surgeons (93 versus 84 per cent). Twenty‐five different SDM‐related outcomes were reported.ConclusionAt present, SDM in surgery is still in its infancy, although surgeons and patients both think of it favourably. Future studies should evaluate the effect of new interventions to improve SDM during surgical consultations, and its assessment using available standardized and validated metrics.

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Section: Resultsmentioning

confidence: 99%

Systematic review of shared decision-making in surgery

Mik

Stubenrouch

Balm

et al. 2018

British Journal of Surgery

126

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“…However, studies have also shown that there is a need to maintain a balance about the provision of right amount and type of information [11]. In the Indian context, as reported in another study as well, patients tend to leave the choice of treatment with the treating team [12]. In such situations, a counsellor/breast navigator can play an effective role in handling the informational and emotional needs of the patients and the family thereby, reducing time-related pressure on the treating team [13,14].…”

Section: Discussionmentioning

confidence: 96%

“…They say, BIf the doctor says, I have to do this, I have to do this…B they don't even question… He's God… that faith cures people more than other stuff but yet if you see amongst the general populace especially the urban, without counselling, they're suffering a huge lot.^ (12).…”

Section: Cultural Normsmentioning

confidence: 99%

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Experiences of Breast Cancer Survivors with Oncology Settings in Urban India: Qualitative Findings

Barthakur

Sharma

Chaturvedi

et al. 2016

Indian J Surg Oncol

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The experience of diagnosis and treatment of cancer leads to significant changes within an individual. In the course of survivorship trajectory, very often cancer survivors are left with the sense, improvements could be done to enhance the quality of cancer care. This article focuses on experiences of breast cancer survivors with oncology setting in urban India. Data was collected from 15 women in South and East India using in-depth interview method. Qualitative interview data was analysed using descriptive phenomenology method. Areas of importance that emerged broadly included informational and emotional categories. Findings reveal quality of cancer care in India can be improved through developing an orientation towards patient-centred style rather than doctor/disease centred approach which has major influence on physical and mental health outcomes. This would require further research and increased emphasis on training of medical as well as paramedical professionals.

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“…It was shown that 35% of Turkish surgeons let their patients choose the technique (BCS or mastectomy) after informing them, whereas the rest tend to direct their patients towards the choice they believe to be most appropriate [7]. When choosing between BCS or mastectomy, independent decision-making rates are over 50% in Western countries compared to as low as 10% in countries like India [8]. The striking outcome of these population-based studies is that in countries where literacy and employment rates are low, patients tend to be excluded from the decision-making process about their surgery.…”

Section: Resultsmentioning

confidence: 99%

Patients' Perspective: What has Changed in Deciding about Breast-Conserving Surgery for Early-Stage Breast Cancer in Turkey?

2018

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Background: This study aims to describe patients' perception of early breast cancer, factors influencing the choice of operation, patients' sources of information about the disease and the seriousness with which this information is considered, and to address what surgeons can do to enlighten their patients prior to decision-making. Methods: Patients were asked to complete a questionnaire consisting of 3 sections: The first section addressed influential factors during the decision-making process; the second pertained to the role of surgeons or health facilities in the process; and the third asked patients to revisit their initial choice of surgery. Results: 237 patients were included in the study. Statistical analyzes regarding demographic features showed that nulliparous, younger than 50 years, never or <5 years married, highly educated, business-owning, employed, and stage I breast cancer patients preferred breast-conserving surgery (BCS) to mastectomy. Conclusion: Although the rate of BCS is a technical quality indicator for breast cancer centers, providing sufficient patient counseling, involving the patient in the decision-making process, and offering every possible surgical option are key to improving quality of life. Systematic counseling should be provided to breast cancer patients who have primary tumors that are eligible for BCS.

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Participation in decision making regarding type of surgery and treatment-related satisfaction in North Indian women with early breast cancer

Abstract: North Indian women do not independently take decision regarding any type of surgery. The reason for opting for either kind of surgery was based on surgeon's recommendation or concern about recurrence. Body image was not an issue amongst majority.

Cited by 13 publications

References 13 publications

Systematic review of shared decision-making in surgery

Systematic review of shared decision-making in surgery

Experiences of Breast Cancer Survivors with Oncology Settings in Urban India: Qualitative Findings

Patients' Perspective: What has Changed in Deciding about Breast-Conserving Surgery for Early-Stage Breast Cancer in Turkey?

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