Making an informed decision of Korean cancer patients: the discrepancy between a patient’s recall of information and the information needed for acquisition of radiotherapy informed consent

Lee, Hye Ran; Lim, Chi-Yeon; Yun, Hyong Geun; Kang, Sung Soo; Kim, Do Yeun

doi:10.1007/s00520-017-3848-8

Cited by 7 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nonetheless, according to the results of the word cloud that visualized the opinions of doctors about the decision-making process ( Figure 1 ), doctors expressed that sufficient time should be spent on explanations and that they must communicate with patients to adequately practice shared decision-making, indicating that they recognized what was required without having been educated on shared decision-making specifically. A lack of time and the requests of caregivers were identified as reasons why doctors found it difficult to practice shared decision-making when making decisions about life-sustaining treatment, which is a similar finding to the results of previous studies [ 17 - 19 ].…”

Section: Discussionsupporting

confidence: 85%

“…In addition, cancer patients and their caregivers often experience considerable anxiety about information provided to them during the shared decision-making process or experience difficulty accepting information in order to maintain hope. Lastly, a lack of time or issues with the health insurance system can make shared decision-making difficult to practice [ 17 , 18 ]. According to the results of this study, doctors often made decisions about withdrawing life-sustaining treatment without having received sufficient education about shared decision-making (76.2%) and perceived this as a barrier to using practicing shared decision-making when making decisions about life-sustaining treatment ( Table 4 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Awareness of Doctors’ Shared Decision-Making in Life-Sustaining Care Decisions

Kim

Lee

et al. 2021

Korean J Hosp Palliat Care

Self Cite

View full text Add to dashboard Cite

Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decisionmaking process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Awareness of Doctors’ Shared Decision-Making in Life-Sustaining Care Decisions

Kim

Lee

et al. 2021

Korean J Hosp Palliat Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…In contrast to this, the level of uncertainty was higher in patients from cohort 2: for 18% of the patients, the treatment goal remained partially unclear and 7% of the patients did not know the treatment goal at all. Subgroup analysis showed that these patients received palliative treatment, which implies communication weaknesses between the treating oncologists and the patients, since full disclosure of a life-threatening diagnosis can be challenging and misconception in cancer communication is a common problem [ 18 ]. Retrospectively, 40% of the patients missed information about alternative therapies.…”

Section: Discussionmentioning

confidence: 99%

Struggling with extensive informed consent procedures for cancer trials—is there even a benefit for the patients?

Tilch

Schranz

Moringlane

et al. 2022

Support Care Cancer

View full text Add to dashboard Cite

Purpose Informed consent procedures in clinical trials often differ in length and complexity to those in clinical routine care. Little is known about the benefit of extensive procedures as intended in clinical trials compared to procedures in routine cancer treatment. Methods In two different clinical studies performed at a comprehensive cancer center, we compared patients’ comprehension and satisfaction of current informed consent procedures in routine clinical care with the level of comprehension and satisfaction of patients treated within clinical trials. Patients with a new cancer diagnosis and recent informed consent received a questionnaire about satisfaction, comprehension, time management, and physician–patient relationship of the informed consent process. Patients in cohort 1 consented to cancer treatment within a clinical trial and were additionally interviewed in a structured way; patients in cohort 2 consented to “standard” chemotherapy and received a follow-up questionnaire after 6 months. Results In cohort 1, 82 patients completed the questionnaire and had an additional structured interview. They were treated in 41 different trials, receiving up to 40 pages of educational material. In cohort 2, 89 patients completed the first and 52 completed the follow-up questionnaire after receiving a standard informed consent form of 6 pages. Subjective understanding and satisfaction with the information provided was equally very high. However, deficits in objective understanding were observed in both cohorts. Conclusion Extensive informed consent procedures for clinical cancer trials have not been associated with a higher level of satisfaction or measurable objective understanding; therefore, the benefit seems to be limited.

show abstract

“…Moreover, a recent article showed that many patients misinterpret the goal of interventions. The framing effect is one of the most powerful factors affecting a patient's decision-making (H. R. Lee, Lim, Yun, Kang, & Kim, 2018). Although the framing effect has been studied in various medical situations, the effect of the word(s) and content in advance directives on individual's decision-making has not been thoroughly evaluated.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Contents in Advance Directives on Individuals’ Decision-Making

et al. 2018

Self Cite

View full text Add to dashboard Cite

Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded “accept the special interventions” on the reference form. However, the majority (70%–90%) chose “refuse the interventions” on the negative form. With respect to the religious form, 70% to 80% chose “not decided yet.” Participants who refused special life-sustaining treatments were older, female, and with better prior knowledge about advance directives. Our findings imply that the specific content of advance directives could affect decision-making with regard to various interventions for end-of-life care.

show abstract

Making an informed decision of Korean cancer patients: the discrepancy between a patient’s recall of information and the information needed for acquisition of radiotherapy informed consent

Abstract: Many Korean cancer patients misunderstand the aims of treatment and half of participants do not want further information. Physicians should address whether specific interventions can solve these barriers so that Korean cancer patients can make truly autonomous treatment decisions.

Cited by 7 publications

References 12 publications

Awareness of Doctors’ Shared Decision-Making in Life-Sustaining Care Decisions

Awareness of Doctors’ Shared Decision-Making in Life-Sustaining Care Decisions

Struggling with extensive informed consent procedures for cancer trials—is there even a benefit for the patients?

Effect of the Contents in Advance Directives on Individuals’ Decision-Making

Contact Info

Product

Resources

About