Health professional and consumer views on involving breast cancer patients in the multidisciplinary discussion of their disease and treatment plan

Abstract

BACKGROUND.The aim was to obtain the views of health professionals and patients about the concept of involving breast cancer patients in the multidisciplinary (MD) treatment planning meeting.METHODS.Breast cancer surgeons, nurses, oncologists, and patient advocates completed a mailed questionnaire.RESULTS.The majority of breast cancer health professionals and patient advocates support shared decision‐making (58%–62%). However, less than a third of surgeons (32%), medical (25%), and radiation oncologists (24%) were supportive of involving women in the MD treatment planning meeting. In contrast, 93% of breast cancer advocates and 73% of breast cancer nurses were supportive of this approach. Patient advocates were significantly more in favor than all other groups (χ2 = 148.8, df = 4, P < .001). The common reasons for supporting patient involvement included that it would lead to patients being more informed and empowered, provide them with an opportunity to ask questions, facilitate decision‐making, and improve communication between the patient and the medical team. Health professionals stated that attendance would make patients anxious and that they would have to modify their medical language. Suggestions about how to manage patient involvement included the patient being supported by a breast nurse and pre‐education before the meeting. Patient advocates were significantly more willing to participate in a randomized controlled trial of this process compared with all other groups. (χ2 = 155.15, df = 4, P < .001).CONCLUSIONS.Despite health professional's reservations, patient advocates were highly supportive of including women in the MD meeting. Such a high demand justifies consideration of this option. Cancer 2007. © 2007 American Cancer Society.

Preferred and actual participation roles in operation treatment decision making of patients with colorectal cancer

“…During this process, physicians and patients share information and regarding the patient's disease, risks and benefits of treatment options, personal values and priorities regarding treatment, and ultimately reach an agreement on the treatment to implement [2,3]. Studies have shown that shared decision-making could provide a number of benefits for patients, including a greater sense of personal control, more satisfaction, and better compliance with treatment, and consequently better outcomes [4,5].…”

Guidelines (short version) of the French Otorhinolaryngology – Head and Neck Surgery Society (SFORL) on patient pathway organization in ENT: The therapeutic decision-making process

“…Certain pathology results are of recognized interest in tumoral assessment: thickness, certain histologic forms, expression of certain antigens, etc; • imaging file: usually, all examination results available will be looked at during the meeting, as a final check, which may reveal a suspect element: metastasis, doubtful image, suspicion of second tumor, etc; • general health status and assessment of capacity to withstand treatment: analysis of all complementary examinations performed at initial assessment; • opinion of patient's usual physician, provided directly or reported to a MDTM member. The patient's own physician is aware of the patient's socioeconomic situation, capacities and support; • epidemiological and social data: private and family life, support, friends and relatives; • the possible interest of the patient being present at the MDTM is a matter of debate [12,13] (level of evidence: 4).…”

Tumor Boards from the Perspective of Ambulant Oncological Care

“…Studies report that health professionals feel they have to modify their medical language in the presence of patients and cannot discuss treatment options in the same manner. This may lead, for example, to less accurate reporting or underemphasizing aggressive radiological or histopathological features, which could cause the non-optimal care of patients [9,11,12]. An increase in anxiety in patients participating in tumor boards could not be confirmed [12].…”

“…Assumed patient distress, concerns about possible effects on the decision-making processes (especially if opposing opinions between board members exist), and resource intensiveness (meetings are time consuming) are juxtaposed to patient empowerment, better informed patients, greater patient involvement in decision-making, and improved communication between patients and care providers [9,10,11,12]. Health care professionals seem to be less supportive of patient participation in tumor board meetings, whereas patient advocates and nurses support this approach [11]. Studies report that health professionals feel they have to modify their medical language in the presence of patients and cannot discuss treatment options in the same manner.…”