How does physicians’ decisional conflict influence their ability to address treatment outcomes in a decision-making encounter with an advanced-stage cancer simulated patient? A descriptive study

Abstract

This descriptive study assesses how physicians' decisional conflict influences their ability to address treatment outcomes (TOs) in a decision-making encounter with an advanced-stage cancer simulated patient (SP). Methods: Physicians (N = 138) performed a decision-making encounter with the SP trained to ask for TOs information. The physicians' decisional conflict regarding patients' cancer treatments in general was assessed with the General Decisional Conflict Scale (Gen-DCS). The physicians' decisional conflict regarding the SP's cancer treatments was assessed with the Specific Decisional Conflict Scale (Spe-DCS). Physicians' ability to address TOs during the encounter was assessed with an interaction analysis system: the Multi-Dimensional Analysis of Patient Outcome Predictions (MD.POP). Weekly time spent with cancer patients was assessed with a questionnaire. Results: Physicians' Spe-DCS (β =-.21 ; p = .014) and weekly time spent with cancer patients (β = .22 ; p = .008) predicted the number of TOs addressed during the encounter. Spe-DCS scores predicted nearly all MD.POP dimensions (r =-.18 ; p = .040 to r =-.30 to p < .001) whereas Gen-DCS scores predicted nearly none MD.POP dimensions. Conclusion: Physicians' specific decisional conflict interferes with their ability to address TOs in a decision-making encounter with an advanced-stage cancer SP.

Difficult medical encounters in oncology: What physicians need. An exploratory study

“…Especially, physicians with poorer psychosocial attitudes, as reflected by higher scores on the Physician's Belief Scale, experience encounters as difficult [ 16 ]. Factors negatively influencing communication include among others clinician's communication skills and stress management [ 17 ] as well as specific decisional conflict interfering with the ability of a clinician to address treatment outcomes in a decision-making encounter [ 18 ]. Situational factors of influence include time pressure, conflicts [ 17 , 19 , 20 ] or the delivery of bad news [ 21 ].…”