Who decides? Shared decision-making among colorectal cancer surgery patients in China

Zhai, Huiwen; Lavender, Christopher; Liu, Cong; Wu, Haotan; Gong, Ni; Yu, Changhong

doi:10.1007/s00520-020-05391-3

Cited by 30 publications

(22 citation statements)

References 24 publications

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“…about the reasons of older patients delaying dialysis. We found if patients' attitude were negative and obscure, their families would play a crucial role to make self-referral decision, align with the theme identi ed by Chen et al [30] that family function of medical seeking and ancillary care.…”

Section: Discussionsupporting

confidence: 86%

Self-referral of Chinese patients with advanced chronic kidney disease and treatment decision-making: A qualitative study

Gao¹,

Shan²,

Jiang³

et al. 2020

Preprint

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Rationale, aims, and objectives: Chinese patients with advanced chronic kidney disease (CKD), especially rural patients possibly occur self-referral behavior and then treatment decisions followed. It is unclear the relationship between self-referral and treatment decision-making. Thus, the aim of this study was to explore the perceptions and views of self-referral and treatment decision making among patients with advanced chronic kidney disease. Methods: We conducted semi-structured interviews with 26 patients with advanced kidney disease and 12 nephrologists. Interviews were conducted and analyzed thematically until reaching thematic saturation. Results: We identified three themes reflected: 1) self-referral decision making (self-referral motive, barrier to self-referral, seeking for self-referral information); 2) the views and experience of self-referral care (facilitating shared decision making, imposing psychological pressure, feeling about self-referral communication, challenge to staff-patient relationship); 3) treatment decision making (decisional awareness and roles, cost-benefit trade-off and redicision). Conclusions: Our study identified that organizational and demographic factors, self-referral motives worked together at the self-referral decision-making and treatment decision-making when advanced CKD patients facing with healthcare facilities and treatment options. Those findings suggest stakeholders should accelerate the popularization of peritoneal dialysis technology and establish the CKD screening and management systems. For self-referral patients with advanced CKD, our results suggest specialized dialysis transition care to improve quality of communication and soothe patients’ negative emotion.

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Section: Discussionsupporting

confidence: 86%

Self-referral of Chinese patients with advanced chronic kidney disease and treatment decision-making: A qualitative study

Gao¹,

Shan²,

Jiang³

et al. 2020

Preprint

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“…As a result, adult children have become the key decision makers in choosing the mode of end-of-life care for the elderly. So, when popularizing hospice palliative care, family members are also an important group that cannot be ignored ( Zhai et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Life-and-Death Attitude and Its Formation Process and End-of-Life Care Expectations Among the Elderly Under Traditional Chinese Culture: A Qualitative Study

Lei

Gan

Gu³

et al. 2021

J Transcult Nurs

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Introduction With the global aging process intensified, the demand for end-of-life care has surged, especially in China. However, its development is restricted. Understanding the life and death attitude among the elderly and its formation process, and clarifying their needs, are so important to promote social popularization of end-of-life care. Methodology This qualitative study included 20 elderly residents in Nan and Shuangbei Communities, Chongqing City, People’s Republic of China. Data were collected through semistructured in-depth individual interviews and processed by thematic analysis method. Results Three themes and eight subthemes were identified: Characteristics of formation process (passive thinking, closed and single), life-and-death attitude (cherish and enjoy life, quality of life priority, let death take its course) and expectations of end-of-life care (preferences, basic needs, good death). Discussion Life-and-death attitude and end-of-life care expectations of the elderly support the development and delivery of end-of-life care. Furthermore, the individual-family-hospital linkage discussion channel needs to be further explored.

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“…Our findings show that the most commonly reported perceived and preferred decision-making role in all countries was no patient involvement. This is likely due to the fact that countries involved in this study can be identified as collectivistic societies, where the family is a main stakeholder in decisions 5 , 35 – 38 and a more paternalistic view of physicians is prevalent. 37 These findings suggest that despite the evidence on increasing support for and promotion of SDM in high-income Asian countries, 39 – 41 a passive role in decision-making may still be commonly experienced and preferred among advanced cancer patients in low and middle income countries in Asia.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

Özdemir

Malhotra

Teo

et al. 2021

MDM Policy & Practice

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Purpose. We investigated 1) perceived roles in decision-making among advanced cancer patients in 5 Asian countries 2) associations of patient characteristics with these roles, and 3) the association of perceived roles with quality of life and perceived quality of care. Methods. We surveyed 1585 patients with stage IV solid cancer. Multinomial logistic regressions were used to analyze associations of patient characteristics with decision-making roles. Multivariate regressions were used to analyze associations of decision-making roles with quality of life and care. Results. The most common perceived-role was no patient involvement. Most patients (73%) reported roles consistent with their preferences. Being male, nonminority, higher educated, aware of advanced cancer diagnosis, and knowledge of cancer diagnosis for ≥1 year were associated with higher levels of patient involvement in decision-making. Compared to no patient involvement, joint decision-making (together with physicians/family) was associated with higher social (β = 2.49, P < 0.01) and spiritual (β = 2.64, P < 0.01) well-being, and better quality of physician communication (β = 9.73, P < 0.01) and care coordination (β = 13.96, P < 0.01) while making decisions alone was associated with lower emotional (β = −1.43, P < 0.01), social (β = −2.39, P < 0.01), and spiritual (β = −2.98, P < 0.01) well-being. Conclusions. Findings suggest that a substantial number of advanced cancer patients were not (and preferred not to be) involved in decision-making. Despite this finding, joint decision-making together with physicians/family was associated with better quality of life and care. Implications. Physicians should explain the benefits of shared decision making to patients and encourage participation in decision-making, while ensuring that patients feel supported and do not find decision-making overwhelming.

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Who decides? Shared decision-making among colorectal cancer surgery patients in China

Cited by 30 publications

References 24 publications

Self-referral of Chinese patients with advanced chronic kidney disease and treatment decision-making: A qualitative study

Self-referral of Chinese patients with advanced chronic kidney disease and treatment decision-making: A qualitative study

Life-and-Death Attitude and Its Formation Process and End-of-Life Care Expectations Among the Elderly Under Traditional Chinese Culture: A Qualitative Study

Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

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