Meeting the Decision-Making Preferences of Patients With Breast Cancer in Oncology Consultations: Impact on Decision-Related Outcomes

被引:116
作者
Brown, Richard [1 ]
Butow, Phyllis [2 ]
Wilson-Genderson, Maureen [1 ]
Bernhard, Juerg [3 ,4 ]
Ribi, Karin [3 ]
Juraskova, Ilona [2 ]
机构
[1] Virginia Commonwealth Univ, Sch Med, Richmond, VA 23298 USA
[2] Univ Sydney, Sch Psychol, Sydney, NSW 2006, Australia
[3] Int Breast Canc Study Grp, Coordinating Ctr, Bern, Switzerland
[4] Univ Hosp Bern, Inselspital, CH-3010 Bern, Switzerland
关键词
SHARING DECISIONS; INFORMATION; PARTICIPATION; COMMUNICATION; ENCOUNTER;
D O I
10.1200/JCO.2011.37.7952
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose To investigate how involvement preferences of patients with breast cancer change during the treatment decision-making process and determine the impact of meeting patients' expectations on decision-making outcomes. Patients and Methods Participants were 683 patients with breast cancer from 62 oncologists in five different countries recruited to an International Breast Cancer Study Group (IBCSG 33-03) project. Questionnaires elicited patients' pre- and postconsultation preferences for involvement in treatment decision making and whether these were met or not. Decision-related outcomes were assessed postconsultation. Results Before the consultation, most patients preferred shared or patient-directed treatment decision making. After the consultation, 43% of patients' preferences changed, and most shifted toward patient-directed decisions. The actual postconsultation decision was more likely to be made according to postconsultation rather than preconsultation preferences. Compared with patients who were less involved than they had hoped to be, patients who were as involved as they had hoped to be or were even more involved in decision making had significantly better decision-related outcomes. This was true regardless of whether preference change occurred. Conclusion Many patients with early-stage breast cancer have treatment options and approach treatment decisions with a desire for decisional control, which may increase after their consultation. Patients' ultimate involvement preferences were more likely to be consistent with the way the decision was actually made, suggesting that patients need to feel concordance between their preference and the actual decision. Patients who directed decisions, even if more than they hoped for, fared better on all decision-related outcomes. These results emphasize the need for oncologists to endorse and facilitate patient participation in treatment decision making. J Clin Oncol 30: 857-862. (C) 2012 by American Society of Clinical Oncology
引用
收藏
页码:857 / 862
页数:6
相关论文
共 30 条
  • [1] Patients' preferences for participation in clinical decision making: A review of published surveys
    Benbassat, J
    Pilpel, D
    Tidhar, M
    [J]. BEHAVIORAL MEDICINE, 1998, 24 (02) : 81 - 88
  • [2] Bernhard J, PSYCHOONOCOLOGY
  • [3] Bilodeau B A, 1996, Oncol Nurs Forum, V23, P691
  • [4] INFORMATION AND DECISION-MAKING PREFERENCES OF HOSPITALIZED ADULT CANCER-PATIENTS
    BLANCHARD, CG
    LABRECQUE, MS
    RUCKDESCHEL, JC
    BLANCHARD, EB
    [J]. SOCIAL SCIENCE & MEDICINE, 1988, 27 (11) : 1139 - 1145
  • [5] Medical decision-making and communication of risks: an ethical perspective
    Breitsameter, Christof
    [J]. JOURNAL OF MEDICAL ETHICS, 2010, 36 (06) : 349 - 352
  • [6] Seeking informed consent to cancer clinical trials; evaluating the efficacy of doctor communication skills training
    Brown, R. F.
    Butow, P. N.
    Boyle, F.
    Tattersall, M. H. N.
    [J]. PSYCHO-ONCOLOGY, 2007, 16 (06) : 507 - 516
  • [7] Promoting patient participation and shortening cancer consultations: a randomised trial
    Brown, RF
    Butow, P
    Dunn, SM
    Tattersall, MHN
    [J]. BRITISH JOURNAL OF CANCER, 2001, 85 (09) : 1273 - 1279
  • [8] Brown RF, 2010, HDB COMMUNICATION ON, P231
  • [9] Sharing decisions in breast cancer care: Development of the Decision Analysis System for Oncology (DAS-O) to identify shared decision making during treatment consultations
    Brown, Richard F.
    Butow, Phyllis N.
    Juraskova, Ilona
    Ribi, Karin
    Gerber, Daniela
    Bernhard, Jurg
    Tattersall, Martin H. N.
    [J]. HEALTH EXPECTATIONS, 2011, 14 (01) : 29 - 37
  • [10] Patient preferences versus physician perceptions of treatment decisions in cancer care
    Bruera, E
    Sweeney, C
    Calder, K
    Palmer, L
    Benisch-Tolley, S
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2001, 19 (11) : 2883 - 2885