Shared decision‐making and patient control in radiation oncology: Implications for patient satisfaction

Abstract

BACKGROUND: Shared decision-making (SDM) has been linked to important health care quality outcomes. However, to the authors' knowledge, the value of SDM has not been thoroughly evaluated in the field of radiation oncology. The objective of the current study was to determine the association between SDM and patient satisfaction during radiotherapy (RT). The authors also explored patient desire for and perception of control during RT, and how these factors relate to patient satisfaction, anxiety, depression, and fatigue. METHODS: A cross-sectional survey of 305 patients undergoing definitive RT was conducted. Patients self-reported measured variables during the last week of RT. Relationships between variables were evaluated using chi-square analyses. RESULTS: Among study participants, 31.3% of patients experienced SDM, 32.3% perceived control in treatment decisions, and 76.2% reported feeling very satisfied with their care. Patient satisfaction was associated with perceived SDM (84.4% vs 71.4%; P <.02) and patient-perceived control (89.7% vs 69.2%; P <.001). Furthermore, the perception of having control in treatment decisions was associated with increased satisfaction regardless of whether the patient desired control. Increased anxiety (44.0% vs 20.0%; P <.02), depression (44.0% vs 15.0%; P <.01), and fatigue (68.0% vs 32.9%; P <.01) were reported in patients who desired but did not perceive control over their treatments, compared with those who both desired and perceived control. CONCLUSIONS: The findings of the current study emphasize the value of SDM and patient-perceived control during RT, particularly as it relates to patient satisfaction and psychological distress. Regardless of a patient's desire for control, it is important to engage patients in the decision-making process.

The Refusal of Palliative Radiation in Metastatic Non-Small Cell Lung Cancer and Its Prognostic Implications

“…Both shared decision making and patient-perceived control are directly related to patient satisfaction and decreased psychological distress when deciding to receive treatment. 38 Finally, radiation oncologists should consider shorter treatment courses in uncomplicated cases. Nearly half of the patients feel that extended survival is less important than shorter treatment duration and lower costs.…”

Cancer chemotherapy failure: a synthetic view

“…It is important to state that the wish for information may have a positive impact on the patient's mental health, if fulfilled, and a negative one if ignored, above all if it is related to a feeling of powerlessness and to satisfaction with the treatment 37 . In that sense, providing information to the patient, while respecting their demands and their readiness to receive it, and their participation in decisionmaking related to their treatment has a positive impact in their mental health 37 . Even when the patient report that he didn't wishes to have control of his treatment, patients reported satisfaction with care is improved when the physician applies shared decision-making techniques 37 .…”

„Wokół radioterapii miednicy - sprawozdanie z ESTRO 35 w Turynie” „Focus on the pelvic region – report of the conference ESTRO 35 in Turin”

“…Program przede wszystkim ma za zadanie zwiększenie udziału pacjenta w procesie decyzyjnym dotyczącym wyboru optymalnej metody leczenia, poprzez funkcję informacyjną, która stymuluje do zadawania pytań lekarzowi i aktywnego uczestnictwa w procesie leczenia. Zaangażowanie pacjenta w proces wyboru skutkuje zmniejszeniem poczucia konfliktu decyzyjnego, obniża żal z powodu podjętej decyzji, ale także powoduje większe zaangażowanie w sam proces leczenia, lepsze samopoczucie i radzenie sobie z sytuacją choroby [13,14].…”