The desire for shared decision making among patients with solid and hematological cancer

Ernst, Jochen; Kuhnt, Susanne; Schwarzer, Andreas; Aldaoud, Ali; Niederwieser, Dietger; Mantovani-Löffler, Luisa; Kuchenbecker, D.; Schröder, Christina

doi:10.1002/pon.1723

Cited by 44 publications

(56 citation statements)

References 29 publications

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“…With regards to age, we were able to replicate the association found by several other studies that younger patients have a stronger desire to decide alone than older patients [23–25, 28, 30, 32]. In the multivariate analyses, we found that older patients were less likely than younger patients to choose an autonomous role over a shared role.…”

Section: Discussionsupporting

confidence: 83%

Predicting the preferences for involvement in medical decision making among patients with mental disorders

et al. 2017

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BackgroundThe involvement of patients in medical decision making has been investigated widely in somatic diseases. However, little is known about the preferences for involvement and variables that could predict these preferences in patients with mental disorders.ObjectiveThis study aims to determine what roles mentally ill patients actually want to assume when making medical decisions and to identify the variables that could predict this role, including patients’ self-efficacy.MethodDemographic and clinical data of 798 patients with mental disorders from three psychotherapeutic units in Germany were elicited using self-report questionnaires. Control preference was measured using the Control Preferences Scale, and patients’ perceived self-efficacy was assessed using the Self-Efficacy Scale. Bivariate and multivariate regression analyses were conducted to investigate the associations between patient variables and control preference.ResultsMost patients preferred a collaborative role (57.5%), followed by a semi passive (21.2%), a partly autonomous (16.2%), an autonomous (2.8%) and a fully passive (2.3%) role when making medical decisions. Age, sex, diagnosis, employment status, medical pretreatment and perceived self-efficacy were associated with the preference for involvement in the multivariate logistic model.ConclusionOur results confirm the preferences for involvement in medical decisions of mentally ill patients. We reconfirmed previous findings that older patients prefer a shared role over an autonomous role and that subjects with a high qualification prefer a more autonomous role over a shared role. The knowledge about predictors may help strengthen treatment effectiveness because matching the preferred and actual role preferences has been shown to improve clinical outcome.

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Section: Discussionsupporting

confidence: 83%

Predicting the preferences for involvement in medical decision making among patients with mental disorders

et al. 2017

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“…One study in patients with haemato-oncological illnesses [17] reported no association between gender and congruence between preferred and perceived participation.…”

Section: Resultsmentioning

confidence: 99%

Congruence between patients’ preferred and perceived participation in medical decision-making: a review of the literature

Brom

Hopmans

Pasman

et al. 2014

BMC Med Inform Decis Mak

150

164

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BackgroundPatients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients’ preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence.MethodsA systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples.ResultsMean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients.ConclusionThis review suggests that a similar approach to all patients is not likely to meet patients’ wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients’ participation wishes on a regular basis during their illness trajectory.

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“…With regard to decision-making, 51% preferred to leave this to staff. There is evidence suggesting that haematological patients wish to take less active participatory role (63% passive role) in the decision-making process than those suffering from solid cancer (29.7% passive role) [10] , furthermore that patients with chronic heart failure has a relatively high wish of being passive (47.8%) [11] . These studies are indicating that the type of illness may influence on the participatory role.…”

Section: Discussion Of Resultsmentioning

confidence: 99%

Patient participation – to what extent? A survey of patients’ perspectives

Abrahamsen¹,

Nørgaard²,

Draborg³

2014

JNEP

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Objective: The past decades have seen an increasingly patient-centred approach to healthcare delivery, with emphasis on patients' participatory role. Patients understand the participatory role as being provided with relevant information, opportunity to give their opinion on potential treatments, involvement in discussions about their condition, or involvement in the decision-making process. Patients' wishes for participation vary considerably. The aim of this study is to explore patients' assessment of the importance of, preferences for and experience of participation. Methods:A cross-sectional cohort study was conducted. Inpatients and outpatients with diabetes, heart failure or haematological cancer admitted to a hospital in Denmark (N = 1736) received a questionnaire. The results are described by proportions and analysed by Pearson's chi-square test. Results:The questionnaire was returned by 1173 patients (68% response rate) of whom 89% found participation very important. The same proportion perceived adequacy of information, 90% expressed a preference for consultation in decision-making and 51% wanted to leave the decisions to staff. Seventy-two percent experienced participation. However, 54% of the respondents who received adequate information and 51% of those who wanted to be consulted did not prefer to make decisions themselves. Sixty percent of the respondents reported a mismatch, as they did not want participation but had nevertheless been involved by staff. Conclusions:Patients find participation of great importance, they feel adequately informed and prefer being consulted in decision-making while they do not necessarily want to make the decisions themselves. We found considerable variation in patients' level of preferred participation and a mismatch between levels of preferred and received participation.

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The desire for shared decision making among patients with solid and hematological cancer

Cited by 44 publications

References 29 publications

Predicting the preferences for involvement in medical decision making among patients with mental disorders

Predicting the preferences for involvement in medical decision making among patients with mental disorders

Congruence between patients’ preferred and perceived participation in medical decision-making: a review of the literature

Patient participation – to what extent? A survey of patients’ perspectives

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